Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons
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Approximately 20% of patients with ankle fractures demonstrate evidence of syndesmotic injuries. As intra-operative measurements have high specifity but low sensitivity for identifying injuries to the distal tibio-fibular syndesmosis, numerous measurements have been developed to assess pre-operative syndesmosis integrity. Several factors affecting measurements on conventional radiographs and computed tomography (CT) images have been identified. The influence of the rotational position of the hindfoot during imaging, however, remains unclear. ⋯ DRRs and axial CT images require reliable reconstructions to allow accurate assessment of the TFCS, TFO, and MCS.