16 papers · updated 2026-09-26 · Orthopaedic Trauma · All topics
The newest papers on ankle fractures from the orthopaedic journals The Reduction reads, newest first, each with a one-line summary. The list is drawn from the digest’s archive and refreshed every week.
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Outcomes of early vs delayed medial malleolar fixation in the treatment of open ankle fractures.
In open ankle fractures, early medial malleolar fixation shortened hospital stay and reduced reoperations but carried a higher infection risk, especially in bi/trimalleolar injuries, urging caution in higher-energy fractures.
In a cadaveric study, augmenting suture button syndesmosis repair with either nonanatomic or anatomic AITFL reconstruction similarly improved ankle stability, and adding deltoid repair further reduced external rotation, though native rotation was never fully restored.
In ankle fracture ORIF, patients with a formal diabetes diagnosis and poor glycemic control had more revisions and infections than those with high HbA1c but no established diagnosis, suggesting diabetes status—not HbA1c alone—better predicts risk.
In a propensity-matched NSQIP analysis, more complex ankle fracture fixations (trimalleolar) took longer but paid less per hour, suggesting wRVU compensation doesn't scale with surgical complexity.
The Effect of Flexible Suture Button Fixation on the Reduction of the Syndesmosis: A Cadaver Study.
In a cadaver study, suture button fixation improved malreduced syndesmoses by about 3 mm translation and 10° rotation regardless of quadricortical versus tricortical placement, suggesting drill hole size drives correction rather than button position.
Both research dissemination and tailored de-implementation strategies substantially reduce unnecessary follow-up radiographs in distal radius and malleolar fractures.
Postoperative CT detected syndesmotic malreduction in 52% of ankles despite acceptable radiographs; malreduction severity correlated with inferior 24-month functional outcomes.
In a cadaveric SER4b ankle model, both syndesmotic screw and deltoid repair restored lateral translation, but only deltoid repair restored rotational and valgus stability.
Beyond the Screw: Mapping the Evidence Landscape of Modern Syndesmotic Fixation.
Suture-button syndesmotic fixation offers advantages over screws including lower reoperation rates, but hybrid fixation strategies need further long-term comparative trials.
Intramedullary fibular nailing in high-risk ankle fractures reduced major complications and enabled earlier weight-bearing versus plate fixation.
GLP-1RA use increases hardware failure and nonunion/malunion risk after ankle fracture fixation without infection increase.
Subtle Syndesmotic Instability.
This review covers diagnosis and management of subtle syndesmotic instability (high ankle sprains), emphasizing physical exam maneuvers, advanced imaging, and arthroscopic stress testing as the diagnostic gold standard.
Three-dimensional planning and patient-specific instruments improve technical precision for supramalleolar osteotomy correction of ankle varus in cavovarus foot deformity.
Chronic Syndesmotic Injuries: Arthrodesis versus Reconstruction.
Reviews management options for chronic syndesmotic injuries, ranging from arthroscopic debridement and ligamentoplasty to tibiofibular fusion depending on instability severity and bone quality.
Acute Deltoid Ligament Repair in Ankle Fractures.
This review argues deltoid ligament repair in ankle fractures improves early radiographic outcomes without changing long-term function, but may benefit patients with high fibular fractures, syndesmotic instability, or higher body weight.
Deltoid Ligament Rupture in Ankle Fracture: Diagnosis and Management.
Deltoid ligament rupture in ankle fractures creates medial instability; repair with suture anchors may prevent chronic symptoms, though evidence remains limited.
Malreduction of the Tibiofibular Syndesmosis in Ankle Fractures
CT scans revealed syndesmotic malreduction in 52% of surgically fixed ankle fractures versus only 24% detected by plain radiographs, showing standard postoperative x-rays are unreliable for confirming accurate syndesmosis reduction.
Predictors of Functional Outcome Following Transsyndesmotic Screw Fixation of Ankle Fractures
In this retrospective multicenter study of syndesmotic screw fixation for ankle fractures, anatomic reduction of the syndesmosis was the only significant predictor of better functional outcome, while 16% of screws may have been unnecessary.
The Functional Consequence of Syndesmotic Joint Malreduction at a Minimum 2-Year Follow-Up
Syndesmotic malreduction after ankle fracture fixation significantly worsens functional outcomes at 2-year follow-up; open reduction and postoperative CT verification recommended.
Population-based epidemiology of 9767 ankle fractures
In this decade-long population study of nearly 10,000 ankle fractures, incidence was 168.7/100,000/year, with lateral malleolus fractures (55%) and falls (61%) predominating, and age/sex patterns diverging notably after adolescence.
Radiographic and CT Evaluation of Tibiofibular Syndesmotic Diastasis: A Cadaver Study
CT scanning detects minor tibiofibular syndesmotic diastasis better than plain radiography, improving instability assessment.
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