Respondent failed to conduct further diagnostic tests to confirm whether collateral damage was present. The patient was further evaluated and found to have had damage to both the deltoid and syndesnotic ligaments, which were not recognized prior to the initial surgery and underwent subsequent surgeries. Respondent failed to diagnose and repair the damage to the ligaments, which was below the standard of care. This failure led to Respondent performing an inaccurate and incomplete procedure (the ORJF surgery). Further, during the surgery, Respondent used a plate that was too short and the facture was malaligned. The standard of care required Respondent to both recognize and properly repair the fracture, the deltoid ligament and syndesnotic ligament. The improper repair led to additional surgeries and may possibly lead to other damage and deformities.