In defence of the posterior malleolus.

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Abstract

[Indexed for MEDLINE] 5. Foot Ankle Clin. 2017 Mar;22(1):35-63. doi: 10.1016/j.fcl.2016.09.004. Syndesmosis Stabilisation: Screws Versus Flexible Fixation. Solan MC(1), Davies MS(2), Sakellariou A(3). Author information: (1)London Foot and Ankle Centre, Hospital of St John and St Elizabeth, 60 Grove End Road, London NW8 9NH, UK; Surrey Foot and Ankle Clinic, Mount Alvernia Hospital, Harvey Road, Guildford, Surrey, GU1 3LX, UK. Electronic address: Matthewsolan1@aol.com. (2)London Foot and Ankle Centre, Hospital of St John and St Elizabeth, 60 Grove End Road, London NW8 9NH, UK. (3)Surrey Foot and Ankle Clinic, Mount Alvernia Hospital, Harvey Road, Guildford, Surrey, GU1 3LX, UK. Orthopedic surgery is not short of situations where there is controversy regarding optimum management. Treating ankle syndesmosis injuries is an example where practice varies widely and there are many questions that remain unsatisfactorily answered. When addressing the type of syndesmosis stabilization that is required it is essential to ascertain the extent of instability. Only then can a logical approach to restoring the ankle mortise be achieved. Fixation of fibula shaft fractures and posterior malleolus fractures can restore sufficient stability to render syndesmosis stabilization unnecessary. The indications and techniques for stabilizing the distal tibiofibular joint are reviewed with clinical examples. Copyright © 2016 Elsevier Inc. All rights reserved. DOI: 10.1016/j.fcl.2016.09.004