Surgical Management of Chronic Syndesmotic Injury A Systematic Review and Meta-Analysis

Abstract

hronic syndesmotic injury is one of major disabiliting injuries affecting ankle. The distal Tibilofibular syndesmosis is a complex Anatomical Structure which has an important role in ankle function and stability. It consists of the interosseous Tibiofibuar ligament (IL), the anterior Tibiofibular ligament (ATiFL), and the posterior Tibiofibular ligament (PTiFL) with the transverse ligament (TL). Injuries to the syndesmosis between the diatal tibia and fibula occur in approximately 1-18% of all ankle sprains, particulaely after external rotation, dorsflexion injuries [3-4], abduction and inversion. During external rotation of the foot the fibula is translated posterioly and rolated externally, which result in high tension of ATiFL this may attribute to isolated rupture of ATiFL, Rupture of ATiFL in its turn, and cause instability of the ankle mortise. Following the injury of syndesmosis, pain during activity, a feeling of instability and weakness of the ankle are also commonly experienced symptoms. Furthermore, tenderness over ATiFL and swelling at level of syndesmosis, a "high sprain" one common signs.