According to a study published online in the Journal of Orthopaedic Trauma, the position of the medial clamp tine during syndesmotic reduction may impact reduction accuracy. 

The researchers conducted a prospective cohort study of 72 patients who underwent operative fixation of ankle syndesmotic injuries using reduction forceps. They assessed malreduction rates with bilateral ankle computerized tomography. The researchers found a significant association between medial clamp position and sagittal plane syndesmosis malreduction, with a 0 percent malreduction rate in the 18 patients where the clamp tine was placed in the anterior third, a 19.4 percent malreduction rate in the middle third, and a 60 percent malreduction rate in the posterior third. In reference to posterior fibular translation, they found an 11.1 percent malreduction when clamp placement was in the anterior third, a 16.1 percent malreduction rate in the middle third, and a 60 percent malreduction rate in the posterior third. They noted no significant association between medial clamp position and coronal plane malreduction. Learn more...