Of the 61 ankle fractures with ruptures of the syndesmotic complex, 25% showed torsional side-to-side differences of more than 10 degrees on proximal and distal CT planes. This CT technique correlated with the AOFAS score and could help determine when early operative revision is indicated.

The temporary blockage of the TFJ results into an altered pattern of dynamic plantar pressure distribution. A constant foot progression angle in relative internal rotation is registered. After removal of the positioning screw the recovered ligamentous structures allow retraction to the anatomic position. But, concerning fibular torsional differences > 15 degrees osseous fixation leads to alterated fpa presented as diminished external rotation of the foot of the formerly fractured ankle with consecutive dysfunction of the physiologic kinematic of movement and eventual provocation of posttraumatic arthritis.