The fate of the syndesmosis in type C ankle fractures: a cadaveric study

Ankle fractures that involve a fracture of the fibula above the syndesmosis (AO type C) associated with a medial lesion are always said to indicate rupture of the inferior tibiofibular syndesmosis. This study shows that fresh cadaver ankles subjected to a combination of abduction and direct lateral force over the shaft of the fibula consistently produce displaced bimalleolar ankle fractures without disruption of the inferior tibiofibular syndesmosis. The results of this study suggest that the presence of an AO type C ankle fracture does not necessarily indicate diastasis of the inferior tibiofibular joint and, therefore, internal fixation of the syndesmosis of the fracture may not be indicated.