Evaluating the syndesmotic widening is very difficult when interpreting ankle X-rays. Simple approach is to measure the distance between the medial wall of fibula and the incisural surface of the tibia. This should be less than 6mm on both AP and oblique views.

Lauge-Hansen Classificatio: Based on Foot position and the direction of the deforming force. The position of the foot either Supination or pronation and the deforming force External rotation, abduction, or adduction.

 

Bibliography;

Overcompression of the Sndesmosis during ankle fracture Fixation; A case report.

Am J Orthop.2008(5);259-261

The Management of Ankle Fractures in Patients with Diabetes. Current concepts review. JBJS Am.2008;90;1570-8