Management of acute injuries of the tibiofibular syndesmosis

  • Nicholas M. Fort
  • Amiethab A. Aiyer
  • Jonathan R. Kaplan
  • Niall A. Smyth
  • Anish R. KadakiaEmail author
General Review • ANKLE - FRACTURES


The syndesmosis is important for ankle stability and load transmission and is commonly injured in association with ankle sprains and fractures. Syndesmotic disruption is associated with between 5 and 10% of ankle sprains and 11–20% of operative ankle fractures. Failure to recognize and appropriately treat syndesmotic disruption can portend poor functional outcomes for patients; therefore, early recognition and appropriate treatment are critical. Syndesmotic injuries are difficult to diagnose, and even when identified and treated, a slightly malreduced syndesmosis can lead to joint destruction and poor functional outcomes. This review will discuss the relevant anatomy, biomechanics, mechanism of injury, clinical evaluation, and treatment of acute injuries to the ankle syndesmosis.


Ankle fractures Syndesmotic injuries Ligament injury 


Compliance with ethical standards

Conflict of interest

Author Anish Kadakia has received royalties and speaking fees from Accumed, royalties from Depuy, and consulting fees from Arthrex. Authors Jonathan Kaplan and Amiethab Aiyer have received consulting fees from Paragon 28 and Medline. Authors Niall Smyth and Nicholas Fort have no conflicts of interest to report.

Ethical approval

This article does not contain any studies with human or animal participants performed by any of the authors.


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Copyright information

© Springer-Verlag France 2017

Authors and Affiliations

  • Nicholas M. Fort
    • 1
  • Amiethab A. Aiyer
    • 1
  • Jonathan R. Kaplan
    • 2
  • Niall A. Smyth
    • 1
  • Anish R. Kadakia
    • 3
    Email author
  1. 1.University of Miami Miller School of MedicineMiamiUSA
  2. 2.Orthopaedic Specialty InstituteOrangeUSA
  3. 3.Northwestern University Feinberg School of MedicineChicagoUSA

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