{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T18:22:23Z","timestamp":1749925343023,"version":"3.37.3"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008678","name":"Universit\u00e4t Leipzig","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008678","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Incongruent stabilization of the distal tibiofibular joint (syndesmosis) results in poorer long-term outcome in malleolar fractures. The aim was to analyze whether the orientation of the syndesmotic stabilization would affect the immediate reduction imaged in computed tomography (CT).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>The syndesmotic congruity in 114 ankle fractures with stabilization of the syndesmosis were retrospectively analyzed in the post-operative bilateral CT scans. The incisura device angle (IDA) was defined and correlated with the side-to-side difference of Leporj\u00e4rvi clear-space (\u0394LCS), anterior tibiofibular distance (\u0394antTFD) and Nault talar dome angle (\u0394NTDA) regardless of the stabilization technique and separately for suture button system and syndesmotic screw. Asymmetric reduction was defined as \u0394LCS\u2009&gt;\u20092\u00a0mm and |\u0394antTFD|&gt;\u20092\u00a0mm.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Regardless of the stabilization technique, no correlation between the IDA and the \u0394LCS (<jats:italic>r<\/jats:italic>\u2009=\u20090.069), the \u0394antTFD (<jats:italic>r<\/jats:italic>\u2009=\u20090.019) nor the \u0394NTDA (<jats:italic>r<\/jats:italic>\u2009=\u20090.177) could be observed. There were no differences between suture button system and syndesmotic screw. Asymmetrical reduction was detected in 46% of the cases, while sagittal asymmetry was most common. No association was found between the orientation of stabilization device and occurrence of asymmetrical reduction (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). The results of suture button system and syndesmotic screw were comparable in this respect (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Poor correlation between the orientation of the stabilization device and the immediate post-operative congruity of the syndesmosis could be shown. In contrast to current literature, this study did not show difference of suture button system over syndesmotic screw in this regard. Careful adjustment of the fibula in anteroposterior orientation should be given special attention.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00402-021-04073-x","type":"journal-article","created":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T08:16:44Z","timestamp":1628324204000},"page":"3213-3220","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Does the orientation of syndesmosis fixative device affect the immediate reduction of the distal tibiofibular joint?"],"prefix":"10.1007","volume":"142","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9936-5979","authenticated-orcid":false,"given":"Robert","family":"Hennings","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5179-4192","authenticated-orcid":false,"given":"Ulrich J.","family":"Spiegl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolin","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6510-2943","authenticated-orcid":false,"given":"Pierre","family":"Hepp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3769-534X","authenticated-orcid":false,"given":"Johannes K. 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