Development of a Synovial Fistula Through a Screw Hole Following Supramalleolar Osteotomy Hardware Removal: A Case Report.

A synovial fistula is the communication between the synovial space and the skin. In most cases, the fistula tract is located within the soft tissue; therefore, excision and closure of the fistula have been described as surgical treatment. Rarely, fistulas may form within the bone following procedures around the joint, such as core biopsy and bone tunneling for ligament reconstruction. In such cases, the insertion of materials filling the bone tunnel with cement or bone graft was introduced. This report describes a case of synovial fistula in the distal tibiofibular joint through a screw hole following the removal of supramalleolar osteotomy hardware. We present a novel technique to close the communication by inserting a larger sized screw as a plug.