Trauma Care

External fixation is widely used in trauma care for managing bone and soft tissue injuries. These devices are often associated with psychological challenges and are often not followed up with sufficient psychological support for the patient. The specific psychological impact of external fixation following traumatic injuries remains underexplored. This scoping review aimed to synthesize the current literature on the psychological impact of external fixation in trauma patients. A systematic search of CINAHL, Cochrane Library, PsycInfo, PubMed, Scopus, Google Scholar, and EBSCO identified ten studies (2006–2024), from the USA, Europe, Asia, and Oceania to be included based on inclusion criteria of using the device for traumatic injuries (excluding limb lengthening procedures) and assessing psychological outcomes using validated tools. Data extracted included injury type, fixator application, survey type, and mental health outcomes. Common measures included HADS, SF-36/SF-12, PedsQL, CRIES-13, EQ-5D-5L, and patient-reported questionnaires. The findings showed that elevated psychological distress was greatest during early recovery (~1 month). Body image concerns were frequently reported with the fixator in place; however, partial recovery of mental health scores was seen by 12–24 months. These findings emphasize the need for additional research and a greater integration of mental health resources in trauma care protocols involving external fixation. Full article

Background: Quality of life is a foundational component of overall health and is negatively impacted by post-traumatic stress disorder (PTSD). In the last decade, acupuncture treatment has become a popularized treatment option for PTSD, especially for Veterans. Research evidence is needed to provide support for acupuncture as a treatment for PTSD which leads to an enhanced quality of life. Objectives: This paper investigated the changes in health-related quality of life in Veterans with combat PTSD who enrolled in a 5-year randomized (two-arm, parallel-group, prospective, single-blinded) clinical trial, completing either a control (Sham) or acupuncture (Verum) treatment (N = 93). Methods: Health-related quality of life was measured by the Veterans RAND 12-item Health Survey (VR-12). Paired t tests between and among participants’ differences were calculated for the Verum acupuncture group, Sham acupuncture group, and Total group. Results: Veterans who completed acupuncture treatment in either randomized arm (Verum and Sham) had a self-perceived improvement in quality of life when assessing physical and mental health symptoms. Specifically, those who were randomized and completed Verum acupuncture treatment reported the greatest improvement in mental health quality of life. Conclusions: Study results support prior foundational findings that acupuncture has a positive effect on self-reported quality of life by reducing PTSD symptoms in Veterans with combat PTSD, with Verum acupuncture eliciting the greatest improvement on mental health symptoms. Full article

Aim: This study aims to assess the relationship between the time-to-CT and outcomes in trauma patients presenting to a regional Australian hospital. Method: This study is a retrospective analysis of prospectively collected data to review the relationship between time-to-CT and the outcomes of mortality, length of stay, and intrahospital transfer for trauma patients presenting to a single regional Australian hospital between January 2000 and July 2022. Results: There were 127 trauma patients who met the inclusion criteria during the study period. Comparing patients who had a CT performed within 1 h of arrival to patients those who had a CT performed more than 1 h after arrival, there was no statistically significant difference in mortality rate (8.0% vs. 7.7%, p = 1.000), and no statistically significant difference in length of stay (4.5 days vs. 3 days, p = 0.496). Increased age was associated with an increased risk of mortality while First Nations people were found to have a shorter length of stay within hospital. Conclusions: In this cohort study, the time-to-CT was not predictive of increased mortality risk in trauma patients presenting to a regional hospital. The time-to-CT in this regional hospital was comparable to published data from level I trauma centres in Australia. What does this paper add to the literature? This paper is the first to look at the impact of time-to-CT in the regional Australian setting. Full article

Background: Fractured ribs remain a significant cause of morbidity and are associated with severe injuries requiring several healthcare resources and may be associated with prolonged hospital stays that may require an ICU facility. In our facility, we have a high burden of patients sustaining rib fractures, and we aim to compare management options, outcomes, and factors associated with mortality from a single center. Methods: A retrospective review was performed on patients who presented with rib fractures at a Level 1 Trauma facility in Johannesburg, undergoing medical or surgical management. The study included data from 1 July 2011 until 31 December 2020. All patients were identified using the Medibank database. STATA Version 18 software was used for all data analysis. A p-value of <0.05 was considered statistically significant. Injuries were subdivided according to the Abbreviated Injury Severity score as follows, Mild = AIS Grade I–II, Moderate = AIS Grade III, Severe AIS Grade IV–V. Results: There was a total of 940 patients. The median age was 45 (IQR: 34–55) years, with 22% female patients in a cohort of 940. The mechanism of injury was blunt in 96%. Most patients (93%) fractured 3/> ribs. Only 4.6% sustained a flail chest. The median SBP was 126 mmHg (IQR:109–144), and the pulse rate was 91 (IQR: 79–108) beats per minute. The mean Injury Severity Score (ISS) and New Injury Severity Score (NISS) were 17 (IQR: 10–29) and 22 (IQR: 14–34), respectively. The most common associated injuries were chest trauma in 42%, combined abdominal and pelvic trauma in 35%, and severe extremity trauma in 37%. The mortality rate was 17% (159/940). Most patients required medical and supportive management, with only 8% undergoing rib plating (76/940). The mean length of stay was 14 days (IQR: 6–25). Statistically significant factors associated with mortality were rib fractures 3≥, flail chest, higher ISS, severe head, neck, chest, abdomen and pelvis injuries (p-value 0.001) and severe extremity injury (p-value 0.006). Conclusions: Rib fractures remain a common pathology in the trauma population, and these patients can have significant associated injuries. With an appropriate multidisciplinary approach, our study found an 83% survival rate, and only 8% of patients requiring surgical intervention. Poor outcomes in patients are directly linked to the number of ribs involved, the injury severity score, associated injuries, and advanced age. Full article

Post-traumatic lymphedema (PTL) is a chronic and often under-recognized sequela of soft tissue trauma, leading to persistent swelling, functional impairment, and increased risk of infection. While lymphedema is traditionally associated with oncologic interventions, growing evidence highlights the significant burden of PTL in trauma patients. This review provides a comprehensive analysis of the current understanding of PTL, including epidemiology, risk factors, pathophysiology, diagnostic modalities, and treatment strategies. PTL often occurs after high-impact musculoskeletal injuries (such as open fractures with significant soft tissue loss) or burns (especially if deep or circumferential). This risk is increased if injury occurs at critical areas of increased lymphatic density (such as anteromedial leg, medial knee, medial thigh, medial elbow, or medial arm). Advances in imaging techniques, including indocyanine green lymphography and magnetic resonance lymphangiography, have improved early detection and classification of PTL. Management approaches range from conservative therapies, such as complete decongestive therapy (CDT), to surgical interventions, including lymphaticovenous anastomosis (LVA), vascularized lymph node transfer (VLNT), and vascularized lymph vessel transfer (VLVT)/lymph-interpositional-flap transfer (LIFT). We report on our experience with two patients. At our center, we diagnose and stage PTL with ICG lymphography and trial CDT for 6 months. If there is no significant improvement, we recommend LVA. If there is insufficient improvement after 12 months, we recommend LIFT/repeat LVA/VLNT. We also treat open fractures with significant soft tissue defects with LIFT, as prophylaxis against PTL. PTL remains an underdiagnosed condition, necessitating increased awareness and intervention to prevent long-term disability. Full article

Objective: There is scarce reporting of radial head fracture epidemiology and patient characteristics beyond age and sex. This study aimed to describe demographic, socioeconomic, and injury pattern characteristics for people sustaining a radial head fracture admitted to trauma centers over a 15-year period. Methods: Analysis of Victorian Orthopaedic Trauma Outcomes Registry data was conducted to describe the demographic and case characteristics of patients with radial head fractures admitted to collaborating hospitals. Cohort and case characteristics were compared by center type (Level 1 vs. other trauma centers). Results: A total of 991 cases with a unilateral radial head fracture were recorded over 15 years, with 827 admitted to Level 1 trauma centers and 164 admitted to other centers. The mean age at time of injury was 48.7 years (SD 19.7), with male predominance (n = 621, 62.7%). Most patients resided in major cities (n = 824, 85.2%), were treated under the universal healthcare system (n = 546, 56.1%), and had no Charlson Comorbidity Index conditions (n = 738, 74.5%). A higher proportion of patients managed at Level 1 centers were male (65.7% vs. 47.6%), younger (mean 47.7 vs. 53.7 years), living in major cities (86.6% vs. 78.5%), and working prior to injury (71.3% vs. 57.1%). Over 85% of the cohort sustained concomitant injuries, with Level 1 centers receiving a higher proportion of multiple injury cases (87.8% vs. 73.2%). Elbow dislocations constituted the largest proportion of concomitant injuries (n = 257, 25.9%). Conclusions: This study has provided new insights into the demographic characteristics, comorbidity status, and associated injuries of radial head fracture populations admitted to Level 1 and other trauma centers, using long-established registry data. Full article

Background: In recent years, endovascular repair has outpaced open repair of blunt traumatic aortic injury (TAI), calling for updated evaluation of severity grading systems to ensure continued efficacy in guiding clinical decision-making. Methods: A retrospective review assessed all adult presentations of blunt thoracic TAI to a single institution from 2005 through 2018. Associations of severity grade with demographics, presentation variables, intervention, and outcomes were analyzed. Results: Thirty-eight patients were included in the analysis. Repair (all endovascular) was pursued in 20 (53%) patients. By grade, 0% of grade 1, 20% of grade 2, 82% of grade 3, and 0% of grade 4 injuries were repaired. Hospital mortality was 16%, and median hospital length of stay was 18 days (IQR 9, 28). Conclusions: A uniform four-grade severity grading system continues to be useful in guiding clinical management for TAI in an environment that is increasingly utilizing endovascular repair. Full article

Objective: Traumatic anterior skull base fractures can be associated with significant morbidity and are managed based on the method of injury, presence of cerebrospinal leak, clinical stability and other factors. Our objective is to determine factors associated with the development of infection in the management of surgical anterior skull base fractures. Methods: We completed a retrospective review of adult patients with traumatic anterior skull base fractures treated operatively with bi-frontal craniotomy from 2012 to 2022. The statistical analysis was completed with Prism 9.0 software for spearman correlation coefficient analysis. Results: Our study had a total of 51 patients. The average time from arrival to surgery was four days. A total of 20 patients were injured via gunshot wound (GSW) and 31 via other methods of injury. A total of 81% of patients were started on antibiotics prior to surgery, and all patients were kept on antibiotics after surgery. Five patients developed infections. Infection was not correlated with time to surgery, length of stay, type/duration of antibiotics, EVD placement/duration, or lumbar drain placement. However, all but one of the infections were in patients injured by GSWs vs. other mechanisms of injury (p < 0.01), and duration, not merely presence, of lumbar drain was correlated with development of infection (p < 0.01). Conclusions: In the treatment of anterior skull base fractures, time to surgery does not significantly increase risk of infection. However, patients with gunshot wounds have higher risks of infection, and thus more aggressive management should be considered. Full article

Background: Trauma injury scoring systems are essential for standardized assessment, treatment decisions, and outcome prediction in trauma patients. The mechanism, Glasgow Coma Scale (GCS), age, and arterial pressure (MGAP) score offers a simplified approach that is particularly beneficial in resource-limited settings. This study aims to determine the association between the MGAP scoring system and mortality outcomes in trauma patients presenting to the trauma emergency unit (TEU) in a resource-limited setting. Objective: To determine the association between the MGAP scoring system and mortality outcomes in trauma patients presenting to the trauma emergency unit (TEU) in a resource-limited setting. Methods: A retrospective record review was conducted on priority 1 (P1) trauma patients aged 18 years or older who presented to the TEU of a hospital between 1 January 2022 and 31 December 2022. Data extracted from the TEU resuscitation register included age, sex, mechanism of injury, blood pressure (BP), and Glasgow Coma Scale (GCS). The primary outcome was survival versus death. MGAP scores were calculated, and statistical analyses were performed to assess the association between MGAP scores and mortality. Results: A total of 1220 patients were included in this study. The analysis revealed a statistically significant association between MGAP scores and mortality (p < 0.0001). Lower MGAP scores were associated with higher mortality rates. Specifically, patients with MGAP scores ≤ 18 had a mortality rate of 48.1%, while those with scores between 19 and 22 had a mortality rate of 23.5%. The mortality rate was 2.2% for MGAP scores between 23 and 29, and 0% for scores ≥ 30. GCS score and systolic blood pressure were also significantly associated with mortality (p < 0.0001 and p < 0.05, respectively), while the mechanism of injury was not significantly associated with mortality. Conclusions: The MGAP score is a valuable tool for risk stratification in trauma patients in resource-constrained settings, demonstrating a strong inverse correlation with mortality outcomes. Its simplicity and reliance on readily available parameters make it particularly useful for rapid triage and resource allocation in LMICs. These findings support the implementation of the MGAP score in trauma triage protocols and highlight the need for further research to validate its performance in diverse LMIC settings and explore its potential for integration into national trauma care guidelines. Full article

Background: Rib fractures are among the most common thoracic injuries following blunt trauma and are associated with significant morbidity, particularly in elderly and polytrauma populations. Historically managed non-operatively, recent advances have redefined the role of surgical stabilization of rib fractures (SSRF) in improving patient outcomes. The objective of this narrative review is to evaluate current evidence surrounding the management of rib fractures, with a focus on indications for SSRF, surgical techniques, special populations, and future directions in care. Methods: A narrative review of the literature was conducted, incorporating relevant randomized controlled trials, cohort studies, clinical guidelines, and expert consensus statements. Emphasis was placed on patient selection criteria, surgical strategies, multimodal analgesia, and emerging technologies. Results: SSRF has demonstrated benefits in short- and long-term outcomes, including improved pain control, reduced ventilator dependence, shorter ICU and hospital stays, and better functional recovery. These outcomes are most evident in patients with flail chest, severe displacement, or failure of conservative therapy. Minimally invasive techniques and 3D-printed implants represent promising innovations. Despite growing evidence, SSRF remains underutilized due to variability in institutional protocols and access to trained personnel. Conclusions: The management of rib fractures continues to evolve with increasing support for surgical intervention in select patients. Wider implementation of SSRF, guided by standardized protocols and advanced technologies, may improve outcomes and reduce complications in this high-risk trauma population. Full article

Background/Objectives: This study examines the academic discourse surrounding Critical Incident Stress Debriefing (CISD) and Critical Incident Stress Management (CISM) for first responders using Latent Dirichlet Allocation (LDA) topic modeling. It aims to uncover latent topical structures in the literature and critically evaluate assumptions to identify gaps and limitations. Methods: A corpus of 214 research article abstracts related to CISD/M was gathered from the Web of Science Core Collection. After preprocessing, we used Orange Data Mining software’s LDA tool to analyze the corpus. We tested models ranging from 2 to 10 topics. To guide interpretation and labeling, we evaluated them using log perplexity, topic coherence, and LDAvis visualizations. A four-topic model offered the best balance of detail and interpretability. Results: Four topics emerged: (1) Critical Incident Stress Management in medical and emergency settings, (2) psychological and group-based interventions for PTSD and trauma, (3) peer support and experiences of emergency and military personnel, and (4) mental health interventions for first responders. Key gaps included limited focus on cumulative trauma, insufficient longitudinal research, and variability in procedural adherence affecting outcomes. Conclusions: The findings highlight the need for CISD/M protocols to move beyond event-specific interventions and address cumulative stressors. Recommendations include incorporating holistic, proactive mental health strategies and conducting longitudinal studies to evaluate long-term effectiveness. These insights can help refine CISD/M approaches and enhance their impact on first responders working in high-stress environments. Full article

This case report describes index pancreatoduodenectomy in a 32-year-old male following a close-range gunshot wound to the abdomen, with consequent 4 cm pancreatic head defect, duodenal and common bile duct perforation, right kidney laceration, and through-and-through inferior vena cava (IVC) injury. Although standard trauma protocols often favor damage control surgery (DCS) with delayed reconstruction in unstable patients, this patient’s hemodynamic stability—attributed to retroperitoneal self-tamponade—enabled a single-stage definitive approach. The rationale for immediate reconstruction was to prevent the risks associated with delayed management, such as ongoing pancreatic and biliary leakage, chemical peritonitis, and subsequent sepsis or hemorrhage. This case highlights that, in select stable patients with severe pancreaticoduodenal trauma, immediate pancreatoduodenectomy may be preferable to DCS, provided care is delivered in a high-volume hepatopancreaticobiliary (HPB) center with appropriate expertise and resources. Full article

Background: Liver trauma is prevalent following blunt and penetrating injuries. This study examined liver trauma in a South African urban trauma centre, focusing on the unique prevalence of penetrating injuries and surgical interventions. Methods: A retrospective analysis was conducted of 512 priority-one patients with liver trauma from January 2017 to December 2023 at Charlotte Maxeke Johannesburg Academic Hospital. The data collected included demographics, injury mechanisms, liver injury grades, associated injuries, injury severity scores (ISS and NISS), surgical interventions, and mortality rates. Statistical analyses were performed using Stata (V.18) and R software (version 4.3.2). Results: The median age of the patients was 31 years, with a predominance of male patients (91%) and patients of African ethnicity (95%). Penetrating trauma accounted for 73% of the cases. Most liver injuries were minor (grades I–III). There was a 5% overall mortality rate, with a higher rate observed in patients requiring emergency surgery (10% vs. 1% for non-operative management, p < 0.001). Just over half of the patients required emergency laparotomy, and the majority of these patients sustained penetrating liver trauma. Complications occurred in 6.6% of the patients, predominantly biliary in nature. Conclusions: This study highlights the high incidence of penetrating liver trauma in South Africa, which reflects the context of interpersonal violence. The mortality rate aligns with international standards and demonstrates the need for effective management strategies. These findings emphasise the need for tailored approaches to liver trauma based on injury patterns and demographics, and further research is needed to explore the associated mortality and complications. Full article

Background: Occupational therapists assess cognitive function in patients with traumatic brain injury (TBI) to determine the impact of impairments on occupational performance. In acute care settings, occupational therapists’ decision-making regarding the assessment of cognitive function is influenced by multiple factors. Aims: The aims of this study were to explore the perceived influences on choice of cognitive assessment by occupational therapists, the ways in which they incorporate observation of occupational performance in assessment, and their attitudes towards and experiences of implementing performance-based testing (PBT) in acute care. Methods: Fifteen occupational therapists with an average of 16.5 years of clinical experience working in acute care TBI management participated in an individual semi-structured interview. The interviews were conducted in person or online and consisted of six questions about which cognitive assessments they use in acute care, influences on this choice, and their experiences of assessing functional cognition using performance-based testing. Data were analysed using interpretive description. Results: The final four themes included (1) an emphasis on ‘functional observation of occupational performance’ and use of structured and tailored processes to make assessments, (2) ‘individualised and efficient’ assessment methods, (3) contextual influences on assessment choice, including the ‘occupational therapy department culture and hospital context’, and (4) ‘safety and management of risks’. Conclusions: Occupational therapy assessment of functional cognition in acute care depends on comprehensive understanding of individual patient-specific factors. Therapists are influenced by pragmatic factors when choosing assessments, which has led to the modification of standardised tests drawn from occupation-based approaches to fit within the time constraints of the acute care setting. The results indicate that therapists may benefit from guidance on how to safely assess patients’ functional cognition in an individualised way in the acute care setting. Full article

Background/Objectives: Concussions, their physical presentation, and patients’ recovery have been researched and documented numerous times, but the experiences of surviving and recovering from a concussion need to be explored further. The purpose of this study was to examine the lived experiences of NCAA Division I, II, and III student athletes who had suffered from one or more concussions. Methods: The consensual qualitative research (CQR) methodology was employed, guiding the formation of the interview questions and the analysis of the responses. The participants completed a free-response questionnaire as well as a semi-structured virtual interview that utilized a blend of idiographic, inductive, hermeneutic, and interpretive phenomenological approaches. Through their questionnaire and interview responses, they discussed their experience being concussed at a collegiate level. Results: Ten NCAA student athletes described their various physical, cognitive, emotional, and sleep-related symptoms due to receiving their concussion(s). Many of these student athletes reported feelings of loneliness, being misunderstood, or even not feeling “normal or at baseline” during and after their concussion recovery. One primary finding was the key role the athletic trainers played in the student athletes’ recovery process from initially receiving the concussion to their return to play. Conclusions: These findings will help contribute to the knowledge of what it is like to experience one or multiple concussions, the recovery process, and how that process can be improved. Full article

Background/Objectives: Hurricane exposure is a growing public health concern that frequently results in posttraumatic stress symptoms (PTSS) in families. Research suggests that contextual factors, including whether or not individuals evacuate, evacuation stress, perceived sense of control, and peritraumatic distress, contribute to PTSS development. Yet, no known research has evaluated how these variables relate to one another, limiting understanding of how and why evacuation-related circumstances impact PTSS. This study investigated how evacuation experiences and PTSS differ between hurricane evacuees and non-evacuees. Methods: Parents (N = 211) reported on their evacuation experiences and perceptions, as well as their and their child’s PTSS, following Hurricane Ian. Results: Evacuated participants reported greater evacuation stress and greater PTSS in themselves and their child relative to non-evacuated participants. Parents’ sense of control was negatively associated with parent evacuation stress and parent peritraumatic distress in the non-evacuated group only. There were no direct associations between parents’ sense of control and parent or child PTSS in either group. In the non-evacuated group, parent evacuation stress was indirectly related to parent PTSS via parents’ sense of control and parent peritraumatic distress. Similarly, parent evacuation stress was indirectly related to child PTSS via each of the aforementioned variables and parent PTSS in the non-evacuated group only. Conclusions: Stress associated with hurricane evacuation may impact parent’s perceived sense of control, which may contribute to greater parent peritraumatic stress, resulting in greater PTSS among parents and children within families that did not evacuate prior to a hurricane. Findings highlight mechanisms that may inform treatment interventions and public health policy. Full article

The management of penetrating rectal trauma has evolved from a historic 4-D algorithm (Divert, Drain, Direct repair, and Distal washout) to a more selective approach. This case report describes a patient with multiple wounds, including a high-grade extraperitoneal rectal injury resulting from a pelvic explosive injury. The patient was successfully treated with intraluminal vacuum therapy (ILVT). This case highlights ILVT as a novel method for managing complicated blast-related rectal injuries. While there are limited publications on combat-related penetrating rectal injuries that provide evidence-based guidelines, we suggest an aggressive surgical approach combined with negative pressure wound therapy for optimal patient outcomes. Full article

Background: Advancements in surgical wound management have led to improved healing and reduced complications. Incisional negative pressure wound therapy (iNPWT) is a technique that applies sub-atmospheric pressure to closed surgical wounds, enhancing blood flow, minimizing edema, and promoting tissue repair. Initially developed for chronic wounds, its use has expanded across multiple surgical specialties, including orthopaedic trauma surgery, to reduce complications such as dehiscence, infection, and prolonged healing. While traditional wound care relies on standard closure methods with simple dressings, iNPWT offers additional mechanical support and may lower the risk of deep surgical site infections (SSIs). This review examines the current evidence on iNPWT’s role in preventing SSIs following surgery for lower extremity fractures to guide clinical decision-making and improve patient outcomes. Methods: A systematic search through PubMed and MEDLINE utilizing our inclusion and exclusion criteria yielded seven randomized controlled trials and randomized prospective cohort studies that were subsequently analyzed to determine iNPWT effectiveness. Results: Of the seven studies, five showed a decreased SSI rate compared to standard wound dressing, with the other two exhibiting an increased infection rate. Conclusions: This review critically examines existing literature on iNPWT, analyzing level I and II studies on deep SSI rates in traumatic fractures. The evidence remains inconclusive on whether iNPWT offers a significant advantage over standard wound dressings, highlighting the need for further research to clarify its efficacy and clinical application. Full article

Introduction: The anatomy of the distal tibiofibular joint (DTFJ) has been demonstrated to influence the radiological outcome of reduction with syndesmotic screw fixation in the course of ankle fracture treatment. The objective of this study was to describe the anatomy of the DTFJ and to analyze the effect of incisura anatomy on syndesmotic stabilization with suture button systems (SBS), also in the context of their flexible nature of fixation. Materials and Methods: Forty-four (21 females, 23 males) consecutive postoperative bilateral computed tomography scans after stabilization of the DTFJ by SBS in the course of operative treatment of unstable ankle fractures were retrospectively analyzed. The anatomy of the DTFJ was evaluated by examining the following parameters: depth of the tibial incisura (DI), rotation of the incisura (ROI), Nault talar dome angle (NTDA), Leporjärvi clear space (LCS), anterior tibiofibular distance (antTFD), and fibula engagement (FE). The side-to-side (Δ) of LCS, NTDA, and antTFD, which analyzed the reduction result, were correlated with DI, FE, ROI, and NTDA, as well as the transverse offset (TO), reflecting the flexible nature of fixation. Results: Patients with slight overtightening (ΔLCS > −1 mm) showed a fibula that protruded less into the incisura on the native side (smaller FE) compared to symmetrical reduced patients and to patients with slight diastasis (p < 0.05). There was no relationship between the parameters describing the anatomy of the incisura and parameters assessing the parameter of the “flexible nature of fixation” (rs < 0.300). Regarding the anatomical parameters, it was observed that there were inter-individual differences of more than 4 mm (p > 0.05). Conclusions: The considerable inter-individual anatomical variability of the DTFJ was confirmed. The morphological configuration of the incisura has no impact on the immediate radiological reduction result after SBS stabilization of the DTFG, as determined by CT. The extent of the flexible nature of fixation is also not affected by the morphology of the incisura. Stabilization of the DTFJ can be performed regardless of the anatomical configuration. Full article