Controversies in ankle fracture treatment. Indications for fixation of stable Weber type B fractures and indications for syndesmosis stabilization.

Although the treatment of ankle fractures is often straightforward, several controversies remain. This article reviews the need for open reduction and internal fixation of the displaced supination-external rotation fracture, and contrasts the studies that mandate anatomic reduction with clinical results. The many issues surrounding syndesmosis fixation are also reviewed, including the need for fixation of distal fractures and the timing of screw fixation.