Syndesmosis Injuries
(AKA “high ankle sprain”)
Just above the ankle joint is an important joint called the distal tibiofibular joint (syndesmosis), this can be injured in isolation or in combination with ankle fractures.
Anatomy of the distal tibiofibular syndesmosis demonstrating the three strong ligamentous bands
When these important ligaments do not provide stability, the ankle remains somewhat painful and accelerated arthritis can develop in the joint.
A common presentation is a patient who is rehabilitating from an ankle sprain and not improving after 4-6 weeks.This is a common sporting injury with an impact to the lower leg or a rotational force. Typically an MRI scan or a weight bearing CT scan is used to confirm the clinical diagnosis.
Diagram demonstrating the location of a syndesmosis injury
Treatment options:
In very rare circumstances these are suitable for non operative management. But this is a minority of cases.
Operative treatment is typically offered to patients for this injury as most unstable syndesmosis joints have a poor outcome without surgical stabilisation.
Surgeries