Published online Nov 18, 2016. doi: 10.5312/wjo.v7.i11.718
Peer-review started: May 19, 2016
First decision: July 5, 2016
Revised: August 26, 2016
Accepted: September 7, 2016
Article in press: September 8, 2016
Published online: November 18, 2016
Processing time: 180 Days and 11.3 Hours
Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries.
Core tip: The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and management of syndesmotic lesions. Even if syndesmotic injuries are common, the appropriate management is still under discussion. Current treatment options are discussed and future directions are provided.