International Orthopaedics

, Volume 43, Issue 11, pp 2539–2547 | Cite as

Diagnosis and treatment of ankle syndesmosis injuries with associated interosseous membrane injury: a current concept review

  • Guang-Shu Yu
  • Yan-Bin LinEmail author
  • Guo-Sheng Xiong
  • Hong-Bin Xu
  • You-Ying Liu



Tibiofibular syndesmosis injury leads to ankle pain and dysfunction when ankle injuries are not treated properly. Despite several studies having been performed, many questions about diagnosis and treatment remain unanswered, especially in ankle syndesmosis injury with interosseous membrane injury. Therefore, the purpose of this study was to help guide best practice recommendations.


This review explores the mechanism of injury, clinical features, diagnosis methods, and the treatment strategy for ankle syndesmosis injury with interosseous membrane injury to highlight the current evidence in terms of the controversies surrounding the management of these injuries.


Radiological and CT examination are an important basis for diagnosing ankle syndesmosis injury. Physical examination combined with MRI to determine the damage to the interosseous membrane is significant in guiding the treatment of ankle syndesmosis injury with interosseous membrane injury. In the past, inserting syndesmosis screws was the gold standard for treating ankle syndesmosis injury. However, there were increasingly more controversies regarding loss of reduction and broken nails, so elastic fixation has become more popular in recent years.


Anatomical reduction and effective fixation are the main aspects to be considered in the treatment of ankle syndesmosis injury with interosseous membrane injury and are the key to reducing postsurgery complications.


Tibiofibular syndesmosis Interosseous membrane Injuries Management 



computed tomography


magnetic resonance imaging


Authors’ contributions

Guang-Shu Yu participated in the design of the study and performed the statistical analysis. Yan-Bin Lin conceived the study and participated in its design and coordination and helped to draft the manuscript. All the authors read and approved the final manuscript. Guo-Sheng Xiong participated in literature search and data integration. Hong-Bin Xu and You-Ying Liu participated in statistical analysis of data.


Guang-Shu Yu is currently receiving grants from Fujian Provincial Natural Science Foundation of China (2016 J01597), Fuzhou Science and Technology Plan Project of China (2017-S-130-5). Our team was funded by the provincial key clinical special construction project in Fujian Province. Our team has received funding from provincial-level clinical key specialist construction projects (2018 NO: 145). For the remaining authors, none were declared.

Compliance with ethical standards

Availability of data and material

We state that all data generated during the present study are included in this article.

Competing interests

The authors declare that they have no competing interests.


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© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Department of OrthopaedicsFuzhou Second Hospital Affiliated to Xiamen UniversityFu ZhouPeople’s Republic of China
  2. 2.Graduate schoolFujian University of Traditional Chinese MedicineFu ZhouPeople’s Republic of China

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