Abstract
The distal tibiofibular syndesmosis provides stability to the ankle mortise, and it
is composed of the anterior inferior tibiofibular, posterior inferior tibiofibular,
interosseous, and inferior transverse tibiofibular ligaments and the interosseous
membrane. Subacute or chronic syndesmosis injuries can present after missed diagnosis
in the acute period or after failed or inadequate nonoperative management. It can
result in chronic ankle pain and progressive degeneration of the ankle. Reconstructive
options for chronic syndesmosis disruption include arthroscopic debridement and screw
fixation, arthrodesis of the syndesmosis, advancement of the anterior tibiofibular
ligament, reconstruction of the interosseous and anterior inferior tibiofibular ligament,
or tri-ligamentous reconstruction of the syndesmosis. We describe a minimally invasive
technique of nearly anatomical reconstruction of the 3 syndesmotic ligaments. The
syndesmosis is debrided and reduced under arthroscopic guidance and anatomical reduction
of the syndesmosis can be achieved. Although we describe this technique for surgeons
to consider, we recognize that a thorough clinical review of the method, complete
with objective and subjective clinical outcome measurements, is warranted before widespread
use of the technique.
Keywords
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Article info
Publication history
Published online: July 16, 2010
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
