{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:49:34Z","timestamp":1787755774294,"version":"build-2784847793"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 30-year-old man presented with left proximal tibia fracture (open Grade 3A) and a transverse lateral malleolus fracture (Weber B) following direct impact injury. Computed tomography revealed a rare posteromedial tubercle fibula fracture at the posterior inferior tibiofibular ligament (PITFL) insertion, with syndesmosis disruption. Initial damage control included an external fixator. Definitive surgery, performed 10 days later, used Herbert screws and a tubular plate, along with syndesmotic screws.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      This case highlights a unique fracture pattern: PITFL avulsion from the fibular end which we wish to name as\n                      <jats:italic toggle=\"yes\">Patel-Sharma fragment<\/jats:italic>\n                      . Identifying this fragment is essential as it needs to be fixed to ensure posterior syndesmosis ring stability.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.24.00238","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T14:00:41Z","timestamp":1738245641000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Fibular-Sided Avulsion of Posterior Inferior Tibiofibular Ligament\u2014Patel-Sharma Fragment"],"prefix":"10.2106","volume":"15","author":[{"given":"Sandeep","family":"Patel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2592-1362","authenticated-orcid":false,"given":"Mandeep S.","family":"Dhillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5541-6298","authenticated-orcid":false,"given":"Ankit","family":"Dadra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6207-6889","authenticated-orcid":false,"given":"Ansh","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddhartha","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1]]},"reference":[{"issue":"1","key":"bib1-20250130","first-page":"68","article-title":"The anatomy and mechanisms of syndesmotic ankle sprains","volume":"36","author":"Norkus","year":"2001","journal-title":"J Athl Train."},{"key":"bib3-20250130","first-page":"43","article-title":"An unusual form of fracture of the fibula","volume":"6","author":"Wagstaffe","year":"1875","journal-title":"Thomas Hosp Rep."},{"issue":"1","key":"bib5-20250130","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s12891-018-1989-7","article-title":"Biomechanical efficacy of AP, PA lag screws and posterior plating for fixation of posterior malleolar fractures: a three dimensional finite element study","volume":"19","author":"Anwar","year":"2018","journal-title":"BMC Musculoskelet Disord."},{"issue":"suppl 5","key":"bib6-20250130","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1016\/S0020-1383(17)30743-X","article-title":"Posterior fragment in ankle fractures: anteroposterior vs posteroanterior fixation","volume":"48","author":"Vidovi\u0107","year":"2017","journal-title":"Injury."},{"issue":"5","key":"bib7-20250130","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/S0749-8063(05)80014-3","article-title":"Disruption of the ankle syndesmosis: biomechanical study of the ligamentous restraints","volume":"10","author":"Ogilvie-Harris","year":"1994","journal-title":"Arthroscopy."},{"key":"bib8-20250130","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1097\/01.blo.0000203489.21206.a9","article-title":"Fixation of posterior malleolar fractures provides greater syndesmotic stability","volume":"447","author":"Gardner","year":"2006","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib9-20250130","doi-asserted-by":"crossref","first-page":"2473011421S00891","DOI":"10.1177\/2473011421S00891","article-title":"Anterior malleolar fractures: pathoanatomy, classification and treatment options","volume":"7","author":"Rammelt","year":"2022","journal-title":"Foot Ankle Orthop."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.24.00238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:50:49Z","timestamp":1787752249000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.24.00238"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.24.00238","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}