{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:14Z","timestamp":1783509314515,"version":"3.55.0"},"reference-count":26,"publisher":"MDPI AG","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    The fact that lateral malleolar fracture is accompanied by posterior malleolar fracture may adversely affect syndesmosis malreduction rates. We aimed to compare syndesmosis malreduction rates determined on postoperative radiographs between isolated lateral malleolar fractures and lateral malleolar fractures accompanied by posterior malleolar fractures.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We retrospectively examined 128 operative patients: 73 with isolated lateral malleolar fractures (group L) and 55 with lateral + posterior malleolar fractures (group LP). In group LP, no patients received posterior fragment fixation. In both groups, indirect syndesmosis fixation was performed with a single screw after open reduction and internal fixation of the lateral malleolus. Patient age, sex, fracture side, fracture type (Lauge-Hansen and Danis-Weber classifications), Kellgren-Lawrence osteoarthritis classification, syndesmotic incongruency on postoperative radiographs, syndesmotic malreduction of postoperative fibula fracture, fracture union time, complication rates, accompanying injuries, and preoperative and postoperative radiographic syndesmotic measurements (tibiofibular overlap, tibiofibular clear space, medial clear space) were recorded, and the groups were compared.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Mean \u00b1 SD age was 44.32 \u00b1 15.66 years in group L and 48.93 \u00b1 14.03 years in group LP (\n                    <jats:italic>P<\/jats:italic>\n                    = .087). There were no significant differences in preoperative and postoperative tibiofibular distance, tibiofibular overlap, and medial clear space values between groups (\n                    <jats:italic>P<\/jats:italic>\n                    &gt; .05). The prevalence of grade 2 fractures according to the Kellgren-Lawrence classification was significantly higher in group LP (\n                    <jats:italic>P<\/jats:italic>\n                    = .047). Postoperative syndesmosis malreduction was detected in 12 patients in group L and in nine in group LP (\n                    <jats:italic>P<\/jats:italic>\n                    = .991).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    In lateral malleolar fractures accompanied by small-fragment posterolateral or avulsion-type posterior malleolar fractures, closed syndesmotic screw fixation does not cause syndesmosis malreduction.\n                  <\/jats:p>","DOI":"10.7547\/21-105","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T16:34:16Z","timestamp":1704818056000},"source":"Crossref","is-referenced-by-count":3,"title":["Syndesmosis Injuries in Lateral Malleolar Fractures Accompanied by a Posterior Malleolar Fracture: A Nonfixed Posterior Fracture Fragment May Not Affect Postoperative Tibiofibular Joint Malreduction Rates"],"prefix":"10.3390","volume":"113","author":[{"given":"Ali","family":"Y\u00fcce","sequence":"first","affiliation":[{"name":"Department of Orthopedic and Traumatology, Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulhamit","family":"Misir","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Traumatology, Private Safa Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Yerli","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Traumatology, Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahsin Olgun","family":"Bayraktar","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Traumatology, Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali \u00c7a\u011fr\u0131","family":"Tekin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Traumatology, Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00fcleyman Semih","family":"Dedeo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Traumatology, Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunus","family":"\u0130mren","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Traumatology, Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"G\u00fcrb\u00fcz","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Traumatology, Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"Arch Orthop Trauma Surg","first-page":"505","article-title":"Anatomy and classification of the posterior tibial fragment in ankle fractures","volume":"135","author":"Barton\u00ed\u010dek J","year":"2015","unstructured":"Barton\u00ed\u010dek J, Rammelt S, Kostliv\u00fd K, et al: Anatomy and classification of the posterior tibial fragment in ankle fractures. Arch Orthop Trauma Surg 135: 505, 2015."},{"key":"B2","series-title":"Clin Orthop Relat Res","first-page":"165","article-title":"Fixation of posterior malleolar fractures provides greater syndesmotic stability","volume":"447","author":"Gardner MJ","year":"2006","unstructured":"Gardner MJ, Brodsky A, Briggs SM, et al: Fixation of posterior malleolar fractures provides greater syndesmotic stability. Clin Orthop Relat Res 447: 165, 2006."},{"key":"B3","series-title":"Eur J Trauma Emerg Surg","first-page":"587","article-title":"Posterior malleolar fractures of the ankle","volume":"41","author":"Barton\u00ed\u010dek J","year":"2015","unstructured":"Barton\u00ed\u010dek J, Rammelt S, Tu\u010dek M, et al: Posterior malleolar fractures of the ankle. Eur J Trauma Emerg Surg 41: 587, 2015."},{"key":"B4","series-title":"Clin Orthop Relat Res","first-page":"1129","article-title":"Posterior malleolar stabilization of syndesmotic injuries is equivalent to screw fixation","volume":"468","author":"Miller AN","year":"2010","unstructured":"Miller AN, Carroll EA, Parker RJ, et al: Posterior malleolar stabilization of syndesmotic injuries is equivalent to screw fixation. Clin Orthop Relat Res 468: 1129, 2010."},{"key":"B5","series-title":"Foot Ankle Int","first-page":"66","article-title":"Biomechanical analysis of the \u0131ndividual ligament contributions to syndesmotic stability","volume":"38","author":"Clanton TO","year":"2017","unstructured":"Clanton TO, Williams BT, Backus JD, et al: Biomechanical analysis of the \u0131ndividual ligament contributions to syndesmotic stability. Foot Ankle Int 38: 66, 2017."},{"key":"B6","series-title":"Foot Ankle Int","first-page":"1229","article-title":"Pathoanatomy and associated \u0131njuries of posterior malleolus fracture of the ankle","volume":"38","author":"Mason LW","year":"2017","unstructured":"Mason LW, Marlow WJ, Widnall J, et al: Pathoanatomy and associated \u0131njuries of posterior malleolus fracture of the ankle. Foot Ankle Int 38: 1229, 2017."},{"key":"B7","series-title":"Foot Ankle Int","first-page":"788","article-title":"Malreduction of the tibiofibular syndesmosis in ankle fractures","volume":"27","author":"Gardner MJ","year":"2006","unstructured":"Gardner MJ, Demetrakopoulos D, Briggs SM, et al: Malreduction of the tibiofibular syndesmosis in ankle fractures. 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J OrthopTrauma 29: 574, 2015."},{"key":"B12","series-title":"Osteoarthritis Cartilage","first-page":"363","article-title":"Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren-Lawrence scale is reliable and correlates with clinical symptoms","volume":"23","author":"Holzer N","year":"2015","unstructured":"Holzer N, Salvo D, Marijnissen ACA, et al: Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren-Lawrence scale is reliable and correlates with clinical symptoms. Osteoarthritis Cartilage 23: 363, 2015."},{"key":"B13","series-title":"J Orthop Trauma","first-page":"100","article-title":"Iatrogenic syndesmosis malreduction via clamp and screw placement","volume":"27","author":"Miller AN","year":"2013","unstructured":"Miller AN, Barei DP, Iaquinto JM, et al: Iatrogenic syndesmosis malreduction via clamp and screw placement. J Orthop Trauma 27: 100, 2013."},{"key":"B14","series-title":"Foot (Edinb)","first-page":"157","article-title":"A computed tomography evaluation of two hundred normal ankles, to ascertain what anatomical landmarks to use when compressing or placing an ankle syndesmosis screw","volume":"24","author":"Kennedy MT","year":"2014","unstructured":"Kennedy MT, Carmody O, Leong S, et al: A computed tomography evaluation of two hundred normal ankles, to ascertain what anatomical landmarks to use when compressing or placing an ankle syndesmosis screw. Foot (Edinb) 24: 157, 2014."},{"key":"B15","series-title":"J Bone Joint Surg Am","first-page":"489","article-title":"Overtightening of the ankle syndesmosis: is it really possible?","volume":"83","author":"Tornetta P III","year":"2001","unstructured":"Tornetta P III, Spoo JE, Reynolds FA, et al: Overtightening of the ankle syndesmosis: is it really possible? 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Foot Ankle Int 35: 543, 2014."},{"key":"B24","series-title":"J Orthop Trauma","first-page":"102","article-title":"Predictors of functional outcome following transsyndesmotic screw fixation of ankle fractures","volume":"19","author":"Weening B","year":"2005","unstructured":"Weening B, Bhandari M: Predictors of functional outcome following transsyndesmotic screw fixation of ankle fractures. J Orthop Trauma 19: 102, 2005."},{"key":"B25","series-title":"J Bone Joint Surg Am","first-page":"1935","article-title":"The measurement and clinical importance of syndesmotic reduction after operative fixation of rotational ankle fractures","volume":"97","author":"Warner SJ","year":"2015","unstructured":"Warner SJ, Fabricant PD, Garner MR, et al: The measurement and clinical importance of syndesmotic reduction after operative fixation of rotational ankle fractures. J Bone Joint Surg Am 97: 1935, 2015."},{"key":"B26","series-title":"Arch Bone Joint Surg","first-page":"98","article-title":"Syndesmotic malreduction after ankle ORIF; is radiography sufficient?","volume":"1","author":"Rasi AM","year":"2013","unstructured":"Rasi AM, Kazemian G, Omidian MM, et al: Syndesmotic malreduction after ankle ORIF; is radiography sufficient? Arch Bone Joint Surg 1: 98, 2013."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/113\/6\/21-105.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/113\/6\/21-105.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/113\/6\/21-105.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:19:26Z","timestamp":1783505966000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/113\/6\/21105"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":26,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.7547\/21-105","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}