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Deltoid ligament
4%
57/1338
Syndesmosis
93%
1248/1338
Proximal fibula
1%
9/1338
Calcaneofibular ligament
11/1338
Posterior tibial tendon
0%
6/1338
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According to the referenced study by Jenkinson et al, up to 37% of operatively treated ankle fractures can have undetected syndesmotic instability when examined intraoperatively. This is important due to the negative effects of a displaced mortise and the abnormal loading forces seen on the talus with even a 2mm lateral shift. Also, fibular fractures >4.5cm proximal to the mortise are more likely to be associated with syndesmotic instability, especially when deltoid ligament tears are present. When fixing the syndesmosis, Tornetta et al's referenced study has shown that the syndesmotic compression has no negative effects on ankle range of motion.
3.4
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