We found syndesmotic instability to be common after anatomic and stable bony fixation in unstable Weber B SE pattern lateral malleolar fractures. Previously published criteria for syndesmotic instability based on cadaveric studies are not representative of the clinical situation. Syndesmotic instability in conjunction with unstable Weber B SE pattern lateral malleolar fractures must be sought out in the operating room with an intraoperative stress examination.

Comparisons among populations have revealed adaptive variation in growth rate within several species. However, theoretical models suggest that a cost to rapid growth must exist in order to explain why some populations grow slowly. Based on previous work with development of the cranial skeleton in pumpkinseed sunfish, we proposed that rapid growth may compromise the strength of all skeletal elements in vertebrates. Using pumpkinseed from six populations known to differ in their intrinsic growth rates, we correlated strength of scales, in terms of resistance to penetration, with individual growth rate. We found a negative correlation that was consistent both within and among populations. This trade‐off between growth rate and scale strength may have fitness consequences in terms of likelihood of surviving predation attempts or swimming efficiency.

The incidence of CS for Schatzker type VI (18%) and medial plateau fracture-dislocations (53%) is high. When compared with the Schatzker type VI injuries, our data suggest that medial plateau fracture-dislocations may be at increased risk of developing CS after placement of spanning external fixation. We recommend careful monitoring of Schatzker type VI fractures and especially medial plateau fracture-dislocations after placement of spanning external fixators.