Management of syndesmotic injuries: What is the evidence?

Figure 8 A 25-year-old patient with a Maisonneuve injury. Assessment of reduction with intra-operative three-dimensional scan (A-E): After closed reduction and temporary fixation with a k-wire (A) the three-dimensional scan shows malreduction of the distal fibula in the incisura (B). Immediate intraoperative revision was performed (C) with repeated intraoperative three-dimensional scan showing correct reduction of the distal fibula. With k-wire in place, two syndesmotic screws have been placed to stabilize the ankle diastase (E).