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. Syndesmosis instability Isolated syndesmosis injuries, commonly referred to as high ankle sprains, are relatively uncommon. 31 They are usually associated with other lesions of the lateral ankle ligaments and are present in up to 20% of all ankle
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specifically pertaining to the management of distal syndesmosis injuries in rotationally unstable ankle fractures continues to evolve. This is due to the realization that the rate of syndesmosis malreduction has been unacceptably high in the past. The
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the principal strategies of Syndesmosis AND Surgery. The entire search strategy is presented in Supplementary 1 (see the section on supplementary materials given at the end of this article). Table 1 PICOS criteria defining the inclusion and
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Introduction Isolated injuries to the syndesmotic complex occur in approximately 1–17% of all ankle sprains ( 1 , 2 ) and in up to 30% in high-impact sports ( 3 ). Furthermore, the syndesmosis is injured in up to 13% of all ankle fractures
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ligament ruptures and isolated medial malleolar fractures without syndesmotic or lateral instability. Relevant injury to the tibio-fibular syndesmosis and/or deltoid ligament has to be ruled out by either stress or standing radiographs. 23 , 24
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medial border of the fibula and the lateral border of the posterior tibial prominence. This distance in both AP and mortise views should be < 6 mm with an intact syndesmosis. The other parameter is the maximal overlap between the medial border of the
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two columns: lateral and medial. The lateral column consists of the fibula, the syndesmosis and the lateral ligaments. The syndesmosis between the fibula and tibia is formed by the anterior and posterior inferior tibiofibular ligaments (AITFL and PITFL
Department of Orthopaedics and Trauma Surgery, Klinik Gut, St. Moritz, Switzerland
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AO Research Institute Davos, Davos Switzerland
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. Complex fracture patterns, such as multifragment involvement of the lateral malleolus, additional fracture of the medial malleolus, involvement of the dorsal tibial facet or bony avulsion of the syndesmosis are common in ankle fractures of the elderly due
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both diagnosis and treatment. Anatomically, the ankle is the connection between the segments of the foot and the leg. The tibio-talar joint, the subtalar joint, and the distal tibiofibular syndesmosis make up the ankle complex. These articulations
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Department of Traumatology and Reconstructive Surgery including Department of Orthopedic Surgery, Charite Universitätsmedizin Berlin, Berlin, Germany
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ligamentous apparatus of the TC joint can be differentiated into the lateral (LCL), the medial (MCL) and the tibiofibular ligament complex. Among the ligamentous structures of the syndesmosis are the distal anterior tibiofibular ligament (ATIFL), the distal
