Why are syndesmotic ankle injuries associated with an avulsion fracture of fibula misdiagnosed by many doctors?

The avulsion frag...: ...may B very small, & oblique x-rays often needed 2 C them. The injury is quite traumatic & should B suspected after just the exam. If the syndesmosis is minimal, tress films need 2 B done. By many docs R they ortho or ER docs. Most orthopedic surgeons don't miss them. If only the anterior inferior tib/fib is torn, the spred is minimal unless it is stressed. .