{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:08:13Z","timestamp":1782889693341,"version":"3.54.5"},"reference-count":28,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2013,1,18]],"date-time":"2013-01-18T00:00:00Z","timestamp":1358467200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Syndesmotic injuries occur in up to 11% of all ankle injuries. Whereas the optimal fixation of syndesmotic injuries remains controversial, pitfalls in their management can lead to poor outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This is a retrospective study of all ankle fractures operated on at a level 1 trauma center over a 7-year period. All cases with syndesmotic fixation were classified and patients\u2019 notes and x-rays were reviewed. The timing of definitive syndesmotic fixation, the type of fixation (screw size and number, number of cortices), and the number of unplanned, syndesmotic-related reoperations were recorded. Seventy syndesmotic ruptures were operated on during the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 19 unplanned reoperations. The 3 reasons for reoperation identified were failure to diagnose the syndesmotic injury 9\/19 (47%), failure to achieve an anatomic reduction 6\/19 (31%), and loss of reduction due to fixation failure 4\/19 (21%). The type of fixation was not correlated with the failure rate, nor were the experience of the surgeon, the gender or the age of the patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The reoperation rate for syndesmotic fixation may be higher than previously thought. In order to reduce the pitfalls in their treatment, we emphazise the importance of 3 critical points in the management of these injuries: suspect the injury, document the stability of the syndesmosis, and reduce the fibula anatomically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective comparative series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100712470914","type":"journal-article","created":{"date-parts":[[2013,1,18]],"date-time":"2013-01-18T20:14:25Z","timestamp":1358540065000},"page":"345-350","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Common Pitfalls in Syndesmotic Rupture Management"],"prefix":"10.1177","volume":"34","author":[{"given":"Panagiotis D.","family":"Symeonidis","sequence":"first","affiliation":[{"name":"Aristotelian University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas D.","family":"Iselin","sequence":"additional","affiliation":[{"name":"Adelaide Orthosports Clinic, Adelaide, Australia"},{"name":"University of Adelaide, Royal Adelaide Hospital, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mellick","family":"Chehade","sequence":"additional","affiliation":[{"name":"University of Adelaide, Royal Adelaide Hospital, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Stavrou","sequence":"additional","affiliation":[{"name":"Adelaide Orthosports Clinic, Adelaide, Australia"},{"name":"University of Adelaide, Royal Adelaide Hospital, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,1,18]]},"reference":[{"key":"bibr1-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-003-0156-4"},{"key":"bibr2-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/107110070302400410"},{"key":"bibr3-1071100712470914","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198971100-00014"},{"key":"bibr4-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/036354659101900315"},{"key":"bibr5-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/107110079701800602"},{"key":"bibr6-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.77B3.7744931"},{"key":"bibr7-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2007.11.425"},{"key":"bibr8-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/107110079701801103"},{"key":"bibr9-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/107110079701800811"},{"key":"bibr10-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3181b1542c"},{"key":"bibr11-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602701005"},{"key":"bibr12-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200407000-00001"},{"key":"bibr13-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/107110079001000607"},{"key":"bibr14-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200006000-00010"},{"key":"bibr15-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602700801"},{"key":"bibr16-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1016\/S1083-7515(02)00022-0"},{"key":"bibr17-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000161090.86162.19"},{"key":"bibr18-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(05)80015-5"},{"key":"bibr19-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.07.043"},{"key":"bibr20-1071100712470914","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2010.0604"},{"key":"bibr21-1071100712470914","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00661"},{"key":"bibr22-1071100712470914","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.01537"},{"key":"bibr23-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511413455"},{"key":"bibr24-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(02)00422-9"},{"key":"bibr25-1071100712470914","first-page":"595","volume-title":"Manual of Internal Fixation: Techniques Recommended by the AO\/ASIF Group","volume":"1991","author":"Weber BG"},{"key":"bibr26-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200502000-00006"},{"key":"bibr27-1071100712470914","doi-asserted-by":"publisher","DOI":"10.1177\/107110079401500801"},{"key":"bibr28-1071100712470914","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200706000-00002"}],"container-title":["Foot &amp; 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