Ankle FracturesNCT07693933
Biodegradable Magnesium Screws for Unstable Ankle Fracture Surgery
A study testing RemeOs Magnesium-Based Biodegradable Screw in people with Ankle Fractures and Syndesmotic Injury, run by Massachusetts General Hospital at 1 site in United States.
Trial summary
Ankle fractures are among the most common injuries that need surgery. When the broken bones make the ankle unstable, surgeons usually fix them with metal screws and plates. Metal hardware holds the bones in place well, but it can cause irritation, can loosen or break, and often has to be removed in a second surgery… Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Ankle Fractures, Syndesmotic Injury
- What is being tested?
- RemeOs Magnesium-Based Biodegradable Screw
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 28 participants
- Where
- 1 siteUnited States
- Study dates
- Apr 2027to Mar 2029
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18-80 years
- Unstable closed ankle fracture requiring surgical fixation, including unimalleolar, bimalleolar, bimalleolar-equivalent, or trimalleolar fractures
- Fractures may be with or without syndesmotic instability
- Willingness to follow postoperative visits and rehabilitation protocols
- Ability to complete patient-reported outcome measures (PROMs)
Who cannot join
- Body mass index (BMI) > 40
- Open fractures
- Pathologic fractures
- Active infection at the surgical site
- Known allergy or hypersensitivity to magnesium or implant components
- Severe peripheral vascular disease
Show all 13Show fewer
- Uncontrolled diabetes mellitus
- Prior ankle surgery on the affected limb
- Concomitant osteochondral lesions requiring treatment
- Neuromuscular disorders affecting the lower extremity
- Worker's compensation cases
- Pregnancy
- Non-adherence concerns or inability to comply with follow-up requirements
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site
Massachusetts General Hospital
Boston, Massachusetts, 02114
About this study
Official title: Magnesium-Based Screws for Syndesmotic Fixation in Unstable Ankle Fractures
Ankle fractures are among the most common injuries that need surgery. When the broken bones make the ankle unstable, surgeons usually fix them with metal screws and plates. Metal hardware holds the bones in place well, but it can cause irritation, can loosen or break, and often has to be removed in a second surgery later.
This study looks at a different kind of screw called the RemeOs magnesium-based screw. It is made from a magnesium alloy and is designed to slowly dissolve and be absorbed by the body over about two to three years after it has done its job of holding the bone together. Because it dissolves on its own, patients may not need a second surgery to remove the hardware. These screws are authorized by the U.S. Food and Drug Administration (FDA) for use in medial malleolus ankle fractures. In this study, they are being used as an off-label indication.
Read more
The purpose of this study is to learn how well these magnesium screws work and how safe they are when used to repair unstable ankle fractures. The study will enroll at least 25 adults (ages 18 to 80) who have an unstable ankle fracture that needs surgery. All participants will have their fracture repaired with RemeOs screws as part of their normal surgical care.
After surgery, participants will be followed for 12 months. They will return for check-ups at about 6 weeks, 3 months, 6 months, and 12 months. At these visits, the study team will examine the ankle, take X-rays to see how the bone is healing and how the screws are dissolving, ask about any complications, and have participants fill out questionnaires about their ankle function and pain.
The main thing the study measures is ankle function at 12 months, scored using a standard ankle questionnaire (the Olerud-Molander Ankle Score). The study also tracks pain, healing on X-rays, how the screws break down over time, and any complications such as infection, loss of fixation, non-healing, or the need for additional surgery.
The surgery, X-rays, and follow-up visits in this study are the same care patients would receive whether or not they take part. The only research-specific parts are giving consent and filling out the study questionnaires. Taking part is voluntary and does not change the care a patient receives.
Read the detailed description
Background: A substantial proportion of operatively treated lower-extremity injuries are ankle fractures, including unimalleolar, bimalleolar, bimalleolar-equivalent, and trimalleolar patterns, often with associated distal tibiofibular syndesmotic instability. Conventional metallic fixation provides reliable initial stability but carries well-recognized drawbacks, including hardware irritation, implant breakage or loosening, and the frequent need for secondary removal procedures-particularly for syndesmotic screws. Magnesium-based biodegradable implants are designed to provide sufficient mechanical stability during fracture healing while gradually degrading, thereby eliminating routine hardware removal. RemeOs magnesium-based screws (Bioretec), composed of a magnesium-calcium-zinc alloy, medial malleolus ankle fractures and are absorbed over approximately 2 to 3 years.
Design: This is a prospective, single-arm, interventional, post-market clinical follow-up study. A minimum of 25 patients (planned enrollment of 28 to allow for attrition) will be enrolled at participating Mass General Brigham sites. Fellowship-trained orthopaedic foot and ankle surgeons will perform all procedures.
Intervention: All participants will undergo open reduction and internal fixation (ORIF) of their ankle fracture using RemeOs magnesium-based biodegradable screws for fracture fixation and/or syndesmotic stabilization, in accordance with the device Instructions for Use. RemeOs screw types (Screw LAG, Screw COM, Screw FT, and Screw LAG Solid) may be used at the surgeon's discretion. Fixation of additional fracture components may be supplemented with plates, K-wires, or non-resorbable screws as clinically indicated.
Assessments: Participants are evaluated preoperatively (baseline characteristics, radiographs, and patient-reported outcomes) and postoperatively at 6 weeks, 3 months, 6 months, and 12 months, with an optional 9-month visit if delayed healing or complications are suspected. Each follow-up includes clinical examination, radiographic assessment of healing and screw biodegradation, complication assessment, and patient-reported outcomes.
Primary outcome: Functional recovery measured by the Olerud-Molander Ankle Score (OMAS) at 12 months.
Secondary outcomes: OMAS at 3 and 6 months; radiographic fracture healing and alignment; radiographic evaluation of RemeOs screw biodegradation; complication rates (loss of fixation, infection, non-union, revision surgery); pain intensity (Visual Analog Scale); and PROMIS Physical Function and Pain Interference.
Statistical analysis: Longitudinal OMAS changes will be analyzed using a linear mixed-effects model with time as a fixed effect and subject as a random effect. Secondary outcomes will be summarized descriptively; continuous variables compared with paired t-tests or Mann-Whitney U tests as appropriate; time to revision evaluated by Kaplan-Meier analysis where applicable. A p-value < 0.05 is considered significant.
All clinical procedures (surgery, imaging, follow-up) are standard care delivered regardless of study participation; the only research-specific procedures are informed consent and completion of patient-reported outcome measures.
- Conditions
- Ankle Fractures, Syndesmotic Injury
- Being tested
- RemeOs Magnesium-Based Biodegradable Screw
- Keywords
- Magnesium-based screw, Biodegradable implant
- Medical subject headings
- Ankle Fractures, Ankle Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RemeOs Magnesium-Based Biodegradable ScrewDevice
ORIF performed using RemeOs magnesium-alloy biodegradable screws (Screw LAG, Screw COM, Screw FT, and/or Screw LAG Solid) for fixation of any malleolus and/or for syndesmotic fixation where indicated, per the device Instructions for Use. The screws provide mechanical stability during healing and gradually biodegrade over approximately 2-3 years, eliminating the need for routine hardware removal.
| Study group | Role | What they receive |
|---|---|---|
| RemeOs Magnesium Screw Fixation | Experimental | All participants undergo open reduction and internal fixation (ORIF) of their unstable ankle fracture using RemeOs magnesium-based biodegradable screws for fracture fixation and/or syndesmotic stabilization, in accordance with the device Instructions for Use. Screw type is selected at the surgeon's discretion. Additional fracture components may be supplemented with plates, K-wires, or non-resorbable screws as clinically indicated. Participants are followed for 12 months postoperatively. Receives: Device: RemeOs Magnesium-Based Biodegradable Screw |
What is being measured
The primary outcome is the main question the study is designed to answer.
Olerud-Molander Ankle Score (OMAS)
Functional recovery assessed by the Olerud-Molander Ankle Score, a patient-reported instrument scored 0 to 100, where 0 indicates totally impaired and 100 indicates no impairment. Higher scores indicate better ankle function.
Measured: 12 months
Secondary outcomes (5)
Radiographic Fracture Healing and Alignment
Radiographic assessment of fracture union and maintenance of anatomic alignment of the ankle mortise on serial postoperative radiographs.
Measured: 6 weeks, 3 months, 6 months, and 12 months postoperatively
Radiographic RemeOs Screw Biodegradation
Radiographic evaluation of the biodegradation behavior of the RemeOs magnesium-based screws over time, including gas formation and implant resorption.
Measured: 3 months, 6 months, and 12 months postoperatively
Complication Rate
Proportion of participants experiencing complications, including loss of fixation, infection, non-union, and revision surgery.
Measured: 12 months
Pain Intensity
Pain intensity measured on a Visual Analog Scale ranging from 0 (no pain) to 10 (worst imaginable pain); lower scores indicate less pain.
Measured: Baseline, 6 weeks, 3 months, 6 months, and 12 months postoperatively
PROMIS
ROMIS Physical Function and PROMIS Pain Interference. Both are reported as Patient-Reported Outcomes Measurement Information System (PROMIS) T-scores standardized to the US general population (mean 50, SD 10, minimum 0, maximum 100). For Physical Function, higher scores indicate a better outcome. For Pain Interference, higher scores indicate a worse outcome.
Measured: Baseline, 6 weeks, 3 months, 6 months, and 12 months postoperatively
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Jul 2026
- Study startApr 2027 (estimated)
- Primary completionFeb 2029 (estimated)
- Study completionMar 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Ankle FracturesStudies of the same condition, open and under way.
- More trials run by Massachusetts General HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 28 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Massachusetts General Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Bioretec Ltd.
- Responsible party
- Principal investigator, Soheil Ashkani Esfahani, Massachusetts General Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07693933
- Sponsor's protocol ID
- 2026P000142
- Status last verified
- Nov 2026
- First submitted
- 3 Jul 2026
- Last updated
- 6 Nov 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No: Individual participant data will be stored within Mass General Brigham and accessed only by IRB-approved study staff. Per the study protocol, data will not be shared outside the institution, and no biological specimens are collected.
Study at a glance
From the registry record, last updated by the sponsor on 6 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Magnesium-Based Screws for Syndesmotic Fixation in Unstable Ankle Fractures
- ClinicalTrials.gov ID
- NCT07693933
- Acronym / sponsor ID
- 2026P000142
- Conditions
- Ankle Fractures, Syndesmotic Injury
- Keywords
- Magnesium-based screw, Biodegradable implant
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 28 participants (estimated)
- Lead sponsor
- Massachusetts General HospitalUniversity, hospital or other
- Collaborators
- Bioretec Ltd.
- Study start
- Apr 2027 (estimated)
- Primary completion
- Feb 2029 (estimated)
- Study completion
- Mar 2029 (estimated)
- First posted
- 9 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Ankle fractures are among the most common injuries that need surgery. When the broken bones make the ankle unstable, surgeons usually fix them with metal screws and plates. Metal hardware holds the bones in place well, but it can cause irritation, can loosen or break, and often has to be removed in a second surgery later.
This study looks at a different kind of screw called the RemeOs magnesium-based screw. It is made from a magnesium alloy and is designed to slowly dissolve and be absorbed by the body over about two to three years after it has done its job of holding the bone together. Because it dissolves on its own, patients may not need a second surgery to remove the hardware. These screws are authorized by the U.S. Food and Drug Administration (FDA) for use in medial malleolus ankle fractures. In this study, they are being used as an off-label indication.
The purpose of this study is to learn how well these magnesium screws work and how safe they are when used to repair unstable ankle fractures. The study will enroll at least 25 adults (ages 18 to 80) who have an unstable ankle fracture that needs surgery. All participants will have their fracture repaired with RemeOs screws as part of their normal surgical care.
After surgery, participants will be followed for 12 months. They will return for check-ups at about 6 weeks, 3 months, 6 months, and 12 months. At these visits, the study team will examine the ankle, take X-rays to see how the bone is healing and how the screws are dissolving, ask about any complications, and have participants fill out questionnaires about their ankle function and pain.
The main thing the study measures is ankle function at 12 months, scored using a standard ankle questionnaire (the Olerud-Molander Ankle Score). The study also tracks pain, healing on X-rays, how the screws break down over time, and any complications such as infection, loss of fixation, non-healing, or the need for additional surgery.
The surgery, X-rays, and follow-up visits in this study are the same care patients would receive whether or not they take part. The only research-specific parts are giving consent and filling out the study questionnaires. Taking part is voluntary and does not change the care a patient receives.
Detailed description
Background: A substantial proportion of operatively treated lower-extremity injuries are ankle fractures, including unimalleolar, bimalleolar, bimalleolar-equivalent, and trimalleolar patterns, often with associated distal tibiofibular syndesmotic instability. Conventional metallic fixation provides reliable initial stability but carries well-recognized drawbacks, including hardware irritation, implant breakage or loosening, and the frequent need for secondary removal procedures-particularly for syndesmotic screws. Magnesium-based biodegradable implants are designed to provide sufficient mechanical stability during fracture healing while gradually degrading, thereby eliminating routine hardware removal. RemeOs magnesium-based screws (Bioretec), composed of a magnesium-calcium-zinc alloy, medial malleolus ankle fractures and are absorbed over approximately 2 to 3 years.
Design: This is a prospective, single-arm, interventional, post-market clinical follow-up study. A minimum of 25 patients (planned enrollment of 28 to allow for attrition) will be enrolled at participating Mass General Brigham sites. Fellowship-trained orthopaedic foot and ankle surgeons will perform all procedures.
Intervention: All participants will undergo open reduction and internal fixation (ORIF) of their ankle fracture using RemeOs magnesium-based biodegradable screws for fracture fixation and/or syndesmotic stabilization, in accordance with the device Instructions for Use. RemeOs screw types (Screw LAG, Screw COM, Screw FT, and Screw LAG Solid) may be used at the surgeon's discretion. Fixation of additional fracture components may be supplemented with plates, K-wires, or non-resorbable screws as clinically indicated.
Assessments: Participants are evaluated preoperatively (baseline characteristics, radiographs, and patient-reported outcomes) and postoperatively at 6 weeks, 3 months, 6 months, and 12 months, with an optional 9-month visit if delayed healing or complications are suspected. Each follow-up includes clinical examination, radiographic assessment of healing and screw biodegradation, complication assessment, and patient-reported outcomes.
Primary outcome: Functional recovery measured by the Olerud-Molander Ankle Score (OMAS) at 12 months.
Secondary outcomes: OMAS at 3 and 6 months; radiographic fracture healing and alignment; radiographic evaluation of RemeOs screw biodegradation; complication rates (loss of fixation, infection, non-union, revision surgery); pain intensity (Visual Analog Scale); and PROMIS Physical Function and Pain Interference.
Statistical analysis: Longitudinal OMAS changes will be analyzed using a linear mixed-effects model with time as a fixed effect and subject as a random effect. Secondary outcomes will be summarized descriptively; continuous variables compared with paired t-tests or Mann-Whitney U tests as appropriate; time to revision evaluated by Kaplan-Meier analysis where applicable. A p-value < 0.05 is considered significant.
All clinical procedures (surgery, imaging, follow-up) are standard care delivered regardless of study participation; the only research-specific procedures are informed consent and completion of patient-reported outcome measures.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| RemeOs Magnesium Screw Fixation | Experimental | Device: RemeOs Magnesium-Based Biodegradable ScrewAll participants undergo open reduction and internal fixation (ORIF) of their unstable ankle fracture using RemeOs magnesium-based biodegradable screws for fracture fixation and/or syndesmotic stabilization, in accordance with the device Instructions for Use. Screw type is selected at the surgeon's discretion. Additional fracture components may be supplemented with plates, K-wires, or non-resorbable screws as clinically indicated. Participants are followed for 12 months postoperatively. |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Age 18-80 years
- Unstable closed ankle fracture requiring surgical fixation, including unimalleolar, bimalleolar, bimalleolar-equivalent, or trimalleolar fractures
- Fractures may be with or without syndesmotic instability
- Willingness to follow postoperative visits and rehabilitation protocols
- Ability to complete patient-reported outcome measures (PROMs)
Key exclusion criteria (13 listed)
- Body mass index (BMI) > 40
- Open fractures
- Pathologic fractures
- Active infection at the surgical site
- Known allergy or hypersensitivity to magnesium or implant components
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| RemeOs Magnesium-Based Biodegradable ScrewORIF performed using RemeOs magnesium-alloy biodegradable screws (Screw LAG, Screw COM, Screw FT, and/or Screw LAG Solid) for fixation of any malleolus and/or for syndesmotic fixation where indicated, per the device Instructions for Use. The screws provide mechanical stability during healing and gradually biodegrade over approximately 2-3 years, eliminating the need for routine hardware removal. | Device | RemeOs Magnesium Screw Fixation |
Primary outcome
Olerud-Molander Ankle Score (OMAS)
Time frame: 12 months
Functional recovery assessed by the Olerud-Molander Ankle Score, a patient-reported instrument scored 0 to 100, where 0 indicates totally impaired and 100 indicates no impairment. Higher scores indicate better ankle function.
5 secondary outcomes
Radiographic Fracture Healing and Alignment
Time frame: 6 weeks, 3 months, 6 months, and 12 months postoperatively
Radiographic RemeOs Screw Biodegradation
Time frame: 3 months, 6 months, and 12 months postoperatively
Complication Rate
Time frame: 12 months
Pain Intensity
Time frame: Baseline, 6 weeks, 3 months, 6 months, and 12 months postoperatively
PROMIS
Time frame: Baseline, 6 weeks, 3 months, 6 months, and 12 months postoperatively
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Nov 2026.
- Individual participant dataSharing planned: No. Individual participant data will be stored within Mass General Brigham and accessed only by IRB-approved study staff. Per the study protocol, data will not be shared outside the institution, and no biological specimens are collected.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing RemeOs Magnesium-Based Biodegradable Screw in people with Ankle Fractures and Syndesmotic Injury, run by Massachusetts General Hospital at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 6 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Mani Eftekhari, BS (15108506056, meftekhari@mgh.harvard.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Olerud-Molander Ankle Score (OMAS) (time frame: 12 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Nov 2026.