Abstract
Even minor residual fragment malpositioning after internal fixation of ankle fractures
is associated with a worse prognosis. Frequent causes for non-anatomical reduction
are fibular shortening due to comminuted fractures or poor bone quality, translational
or rotational malpositioning of the distal fibula within the tibial incisura with
unstable syndesmosis injuries, and inadequately addressed bony avulsions of the tibiofibular
syndesmosis. After operative treatment of fracture dislocations with syndesmotic fixation,
in case of complex fracture pathoanatomy, and with suspected non-anatomic reduction
in postoperative radiographs, computed tomography imaging of both ankles should be
performed. Correction of relevant malreductions should be performed as early as possible
in order to speed up rehabilitation and to avoid late sequelae due to a load shift
or instability in a weight-bearing joint.
Key words
malleolar fracture - malposition - Chaput fragment - tibial rim - syndesmosis
