Syndesmotic malreduction may be caused by a lag screw used in distal fibula fracture fixation

Anatomical reduction of both the fracture and the syndesmosis is essential to achieve a satisfactory functional outcome in ankle fractures.[1] Stabilization of the syndesmosis is a contentious topic that can be accomplished through a variety of methods and evaluated radiologically.[2] Syndesmotic malreduction occurs when anatomical reduction of syndesmosis is not achieved for a variety of reasons, including an inability to insert the screws in the proper position, failure to reduce the fracture in the anatomical position, and penetration of the deltoid ligament into the medial joint space.[3]