Incisura Morphology as a Risk Factor for Syndesmotic Malreduction

Background:The goal of this study was to objectively assess if rotational or translational syndesmotic malreduction is associated with certain syndesmotic morphologies. Prior studies based on subjective assessment of syndesmotic morphology and reduction have not shown any difference between groups.Methods:Thirty-five prospectively recruited patients with operatively treated syndesmotic injuries were recruited at an Urban Level I Trauma Center. Patients underwent postoperative bilateral computed tomographic (CT) scans of the ankle to assess incisura depth and syndesmotic reduction. The uninjured extremity was used as a control. Side-to-side differences of syndesmotic reduction were measured at several anatomic points and compared to the incisura depth.Results:There was a significant correlation between more shallow syndesmoses and increased anterior translation of the fibula in the incisura (r = −0.63, P ≤ .001). Six of 8 patients with “shallow” (≤2.5 mm) incisura were anteriorly malreduced greater than or...