Syndesmotic Injuries

Clin Podiatr Med Surg. 2024 Jul;41(3):491-502. doi: 10.1016/j.cpm.2024.01.013. Epub 2024 Feb 28.

Abstract

Syndesmotic ankle injuries, though rare in isolation, are complex destabilizing injuries often accompanied by fractures. Misdiagnoses, particularly overlooking posterior malleolus fractures, are common in ankle sprains. Thorough physical examinations, emphasizing high fibular pain and anterior tibia palpation, aid in accurate diagnosis. Grading helps assess injury severity and guiding treatment. Initial imaging involves three ankle views, with stress radiographs enhancing accuracy. If conservative care fails, MRI reveals ligament and tendon damage. Physical therapy may suffice for functional instability; surgical intervention addresses mechanical instability. Syndesmotic fixation debates center on cortices, screw size, reduction methods, and optimal positioning.

Keywords: Ankle; Ankle instability; High sprain; Sprain; Syndesmosis.

Publication types

  • Review

MeSH terms

  • Ankle Fractures / diagnostic imaging
  • Ankle Fractures / surgery
  • Ankle Injuries* / diagnosis
  • Ankle Injuries* / surgery
  • Female
  • Fracture Fixation, Internal / methods
  • Humans
  • Joint Instability / diagnosis
  • Joint Instability / etiology
  • Joint Instability / surgery
  • Magnetic Resonance Imaging
  • Male