Evaluating the Necessity of Distal Tibia-Fibular Syndysmosis Screw Fixation in the Gradual Correction of Angular Lower-Limb Deformities

The use of a distal tibio-fibular syndesmotic screw during TSF-assisted gradual correction of lower-limb angular deformities does not significantly influence radiographic or functional outcomes. Given the additional operative time and resources involved, its routine use should be reconsidered. Larger, prospective studies are warranted to establish definitive clinical guidelines.