Intra-articular fractures involving the ankle joint complex may be associated with significant patient morbidity, particularly if involving disruption and instability of the syndesmotic ligaments. Although this has been relatively well-established within the literature with respect to rotational ankle fractures [1,2], the association and impact of syndesmoticdisruption and malreduction on intra-articular tibial plafond fractures (i.e. pilon fractures) is relatively unknown [3-5].The diagnosis of syndesmotic instability has traditionally been performed through intra-operative stress examination [6], however, there has been a trend with the contemporary literature to identify syndesmoticmalreduction with the use of computed tomography (CT) [7-10]. In fact, a recent study has identified good reliability among several different assessment methods for post-operative syndesmotic reduction in ankle fractures with the use of CT scans [10]. The objective of this investigation was to measure syndesmotic reduction in intra-articularfractures of the tibial plafond.

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