Mahmud Aydın1, Serkan Surucu2, Mehmet Ekinci1, Murat Yılmaz1

1Department of Orthopedics and Traumatology, Sultangazi Haseki Training and Research Hospital, Istanbul, Turkey
2Department of Orthopedics and Traumatology, University of Missouri Kansas City, Kansas City, United States

Keywords: Ankle fracture, fixation, lag screw, malreduction, syndesmosis.


Lag screws used in the anatomical fixation of the fibula can cause syndesmotic malreduction and reveal a previously undocumented cause of malreduction in the literature. We present a 36-year-old male patient who developed an ankle fracture-dislocation after a pronation external rotation injury. The distal fibula fracture of the patient was reduced anatomically, and fixation of the syndesmosis was performed with syndesmotic screws. On the postoperative radiographs, malreduction of the syndesmosis was detected. Afterward, computed tomography was performed on the ankle, which revealed that the lag screw was responsible for the malreduction. The lag screw was removed, and the syndesmosis was anatomically reduced. In conclusion, the lag screw inserted from the anteromedial aspect of the fibula in the fixation of distal fibular fractures can cause malreduction.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.