“IMPRESSION: Expected postsurgical change of the distal fibula and medial malleolus ORIF without significant interval change when compared to the prior study dated 07/23/13.”

The word “interval” is redundant and should be omitted. The time interval is defined by the current and comparison exam dates and doesn’t need to be referenced by name.

“…when compared to the prior study dated 07/23/13” is unnecessarily verbose. Writing “…since the 07/23/13 exam” gives the same information 3 reading-levels less.

The word “exam” is implicit in the comparison date and can be omitted. The phrase could be shortened to just the date “…since 07/23/13.”

Rewritten example:

“IMPRESSION: Expected postsurgical appearance of distal fibula and medial malleolus ORIF not significantly changed since 07/23/13.”