{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:46:33Z","timestamp":1788788793617,"version":"build-2803163510"},"reference-count":20,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"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 &amp; Ankle Specialist"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal placement for a syndesmosis reduction clamp remains an open question. This study compared the center-center axis, which localizes clamp placement using only an internally rotated lateral ankle X-ray, with other common approaches, whose accuracy can only be confirmed using computed tomography (CT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Bone models of anatomically aligned (n = 6) and malreduced (n = 48) limbs were generated from CT scans of cadaveric specimens. Four axes for guiding clamp placement (center-center, centroid, B2, and trans-syndesmotic) were then analyzed, using digitally reconstructed radiographs derived from the bone models. Each axis\u2019 location was defined using angle-height pairs that describe axis orientation along the full anatomical region where syndesmosis fixation occurs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In anatomically aligned limbs, the center-center axis was located on average (\u00b195% CI [confidence interval]), 0.64\u00b0 (\u00b10.50\u00b0) internal rotation, 1.03\u00b0 (\u00b10.73\u00b0) internal rotation, and 2.09\u00b0 (\u00b17.29\u00b0) external rotation from the centroid, B2, and trans-syndesmotic axes, respectively. Fibular displacement altered the magnitude of limb rotation needed to identify the center-center axis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The center-center technique is a valid method that closely approximates previously described methods for syndesmosis clamp placement without using CT, and the magnitude of C-arm rotation needed to transition from a talar dome lateral to a center-center view may be a potential method for assessing syndesmosis reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Levels of Evidence:<\/jats:title>\n                    <jats:p>Level III: Retrospective comparative study<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19386400231213741","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T03:40:41Z","timestamp":1701834041000},"page":"596-605","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Center-Center Image Closely Approximates Other Methods for Syndesmosis Reduction Clamp Placement"],"prefix":"10.1177","volume":"18","author":[{"given":"Nicholas J.","family":"Jackson","sequence":"first","affiliation":[{"name":"J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida"},{"name":"Department of Computer &amp; Information Science &amp; Engineering, University of Florida, Gainesville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Flores","sequence":"additional","affiliation":[{"name":"J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Blake","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8920-1498","authenticated-orcid":false,"given":"Joel B.","family":"Harley","sequence":"additional","affiliation":[{"name":"Department of Electrical &amp; Computer Engineering, University of Florida, Gainesville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W.","family":"Reb","sequence":"additional","affiliation":[{"name":"Orthopedics, Malcom Randall Department of Veterans Affairs Medical Center, Gainesville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5167-9197","authenticated-orcid":false,"given":"Jennifer A.","family":"Nichols","sequence":"additional","affiliation":[{"name":"J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida"},{"name":"Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100718816037"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e31825197cb"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.01726"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00198"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000882"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100716634791"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717744332"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2014.07.001"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100720936215"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/BTF.0000000000000078"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2015.03.008"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.01132"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2016.06.031"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602701005"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000001348"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(90)90074-T"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.01.029"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000296"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-022-09769-0"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B1.BJJ-2020-0844.R1"}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400231213741","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19386400231213741","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400231213741","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:32:22Z","timestamp":1777411942000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19386400231213741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,6]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/19386400231213741"],"URL":"https:\/\/doi.org\/10.1177\/19386400231213741","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,6]]}}}