Haller JM, et al. - In this retrospective comparative study at two level-1 academic trauma centers, researchers evaluated 735 tibial plafond fractures (OTA/AO 43-B3 and 43-C) of 108 subjects managed between January 2006 and December 2015 to assess the incidence and fracture characteristics in relation to syndesmotic injury and also to report the incidence of posttraumatic osteoarthrosis (PTOA). About 2% of cases had missed syndesmotic injury. Nearly 93% of subjects with missed syndesmosis injury developed arthrosis whereas 45% of plafond fractures with acute syndesmosis injury developed arthrosis. They found fewer chances of developing PTOA among candidates with syndesmotic fixation and a ≤10-mm Chaput or Volkmann fragment or fibular avulsion fracture. Overall, 15% of tibia plafond fractures were reported with a syndesmosis or syndesmotic equivalent injury.