Fractures of the malleolus with syndesmotic injury : a challenge to diagnosis and treatment
Fractures of the malleolus associated with syndesmotic injuries are common. Diagnosis of the syndesmotic injury often is missed and requires stress testing. An initial stable syndesmosis on x-ray may get displaced in later x-ray and a high suspicion Index can prevent one from missing this injury. Figure 1 and 2. Accurate reduction and stable fixation of the syndesmosis are critical to outcomes. Unstable syndesmosis is particularly prone to malreduction including translation, rotation, and overcompression. Knowledge of the technical details regarding intraoperative reduction methods and reduction assessment can minimize the risk of syndesmotic malreduction and improve patient outcomes.
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