Foot and Ankle (SG Parekh, Section Editor)

Current Reviews in Musculoskeletal Medicine

, Volume 6, Issue 4, pp 304-312

First online:

Syndesmosis injuries

  • Kenneth J. HuntAffiliated withDepartment of Orthopaedic Surgery, Stanford University Email author 

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Traumatic injuries to the distal tibiofibular syndesmosis commonly result from high-energy ankle injuries. They can occur as isolated ligamentous injuries and can be associated with ankle fractures. Syndesmotic injuries can create a diagnostic and therapeutic challenge for musculoskeletal physicians. Recent literature has added considerably to the body of knowledge pertaining to injury mechanics and treatment outcomes, but there remain a number of controversies regarding diagnostic tests, implants, techniques, and postoperative protocols. Use of the novel suture button device has increased in recent years and shows some promise in clinical and cadaveric studies. This article contains a review of syndesmosis injuries, including anatomy and biomechanics, diagnosis, classification, and treatment options.


Syndesmosis injury High ankle sprain Pronation external rotation Sports injury TightRope Syndesmotic screws