Abstract
An eighteen-year-old patient sustained a fracture-dislocation of the left ankle while playing rugby. The fracture was treated in the emergency department with closed reduction and splinting, followed by open reduction and internal fixation. Subsequently, increased tibiotalar clear space was noted radiographically. Coronal computed tomography images confirmed distal distraction of the talus. This was determined to have resulted from "over-tightening" the syndesmosis. Our surgical treatment consisted of minute manual repositioning of the talus. We advise meticulous scrutiny of intraoperative radiographs to evaluate potential talar distraction. Additionally, comparison radiographs of the contralateral ankle can be an essential component of preoperative and intraoperative assessment of ankle fractures with syndesmotic disruption.
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