case_images: PMC5902103_01
case_images: Preoperative lateral (a), AP (b), and mortise (c) radiographs showing tibiotalar dislocation and impingement of the fibula behind the tibia with no fractures.
case_images: CRIOR2018-7284643.001.jpg
case_images: PMC5902103_01_CRIOR2018-7284643.001.jpg
case_images: fig1
case_images: A 3-view X-ray of the ankle confirmed the dislocation of the fibula posterior to the tibia and posterior dislocation of the talus, while showing the stable intramedullary nail and distal screw with no apparent lucencies (Figure 1).
case_images: Intraoperative lateral radiograph showing placement of syndesmotic screws and the undamaged previously placed tibial nail.
case_images: CRIOR2018-7284643.002.jpg
case_images: PMC5902103_01_CRIOR2018-7284643.002.jpg
case_images: fig2
case_images: The fibula was then held in place with a Kirschner wire and fixed by placing two quadricortical screws through the tibia, using radiographic guidance to avoid the previously placed nail and remaining distal screw (Figure 2).
case_images: Postoperative lateral (a), AP (b), and mortise (c) radiographs showing 2 quadricortical screws stabilizing the syndesmosis with no evidence of hardware failure.
case_images: CRIOR2018-7284643.003.jpg
case_images: PMC5902103_01_CRIOR2018-7284643.003.jpg
case_images: fig3
case_images: At 3 months postoperatively, the fixation continued to remain stable (Figure 3).