A method for detection of lateral malleolar malrotation using conventional fluoroscopy

Recent studies on ankle syndesmosis injuries have shown that a significant amount of rotational malediction of the distal fibula are missed and may lead to poor functional outcome. A new set of radiographic criteria were developed to help detect distal fibula internal and external rotation using conventional fluoroscopy. The criteria were tested using a cadaveric model for Weber C ankle fractures fixed with the fibula in various degrees of internal and external rotation. Using the criteria orthopaedic trauma surgeons were able to improve their accuracy and agreement on assessment of degree and direction of fibula rotation.