Peroneal Artery Danger Zone With Syndesmotic Screw Fixation: A Computed Tomography Angiography Study

This study investigates the risk of injury to the peroneal artery (PA) and its deep perforating branch (dPA) during trans-syndesmotic screw (TSS) fixation in high-risk patients with unstable ankle fractures. The authors conducted a retrospective analysis of computed tomography angiograms to identify the "danger zone" where these vessels are at risk, finding that 98.5% of limbs analyzed were at risk, particularly in the distal fifth of the limb. The findings provide critical measurements to help avoid vascular compromise during surgical fixation in vulnerable populations.