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Treatment of Syndesmotic Injuries of the Ankle: A Critical Analysis Review

Ankle injuries involving the tibiofibular syndesmosis can result from various mechanisms of trauma. Varying levels of soft-tissue injury can result in syndesmotic compromise. Prior studies have found that up to 40% of all athletic injuries are ankle sprains1-3 and it was estimated that 5% to 10% of those, with the prevalence climbing to 35% in collision sports4,5, involved disruption of the tibiofibular syndesmosis6,7. The prevalence of syndesmotic injury has been estimated at 23% of all ankles with fractures6, with disruption prevalences as high as 39% to 45% of ankles with operatively treated lateral malleolar fractures8,9.

Despite being a relatively common injury, much debate remains regarding the definitive fixation of the disrupted tibiofibular syndesmosis. A recent survey highlighted the variability with regard to the treatment of these injuries10. …