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

Int Orthop. 2019 Nov;43(11):2539-2547. doi: 10.1007/s00264-019-04396-w. Epub 2019 Aug 23.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Injuries; Interosseous membrane; Management; Tibiofibular syndesmosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Ankle Fractures / complications
  • Ankle Fractures / diagnostic imaging
  • Ankle Fractures / surgery
  • Ankle Injuries / complications
  • Ankle Injuries / diagnostic imaging*
  • Ankle Injuries / surgery*
  • Fibula / diagnostic imaging
  • Fibula / injuries
  • Fibula / surgery
  • Fracture Fixation, Internal / adverse effects*
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / surgery
  • Humans
  • Interosseous Membrane / injuries*
  • Interosseous Membrane / surgery*
  • Male
  • Practice Guidelines as Topic
  • Soft Tissue Injuries / complications
  • Soft Tissue Injuries / diagnostic imaging
  • Soft Tissue Injuries / surgery
  • Tibia / diagnostic imaging
  • Tibia / injuries
  • Tibia / surgery