Anterior Incisura Fibularis Corner Landmarks Can Safely Validate the Optimal Distal Tibiofibular Reduction in Malleolar Fractures—Prospective CT Study

Background: Distal tibiofibular injuries are common in patients with malleolar fractures. Malreduction is frequently reported in the literature and is mainly caused by insufficient intraoperative radiological evaluation. In this direction, we performed a prospective observational study to validate the efficacy of the anatomical landmarks of the anterior incisura corner. Methods: Patients with malleolar fractures and syndesmotic instability were reduced according to specific anatomic landmarks and had a postoperative bilateral ankle CT. The quality of the reduction was compared to the healthy ankles. Results: None of the controlled parameters differed significantly between the operated and healthy ankles. Minor deviations were correlated to the normal incisura morphology rather than the reduction technique. Conclusions: The anterior incisura anatomical landmarks can be an efficient way of reducing the distal tibiofibular joint without the need for intraoperative radiological evaluation.