[Injuries of the tibiofibular syndesmosis].

Injuries of syndesmotic ligaments can occur in isolation or as a component of fractures with a latent or manifest diastasis between the distal tibia and fibula. Bony avulsions of the anterior or posterior tibial rim or the anterior fibula are frequently detected. Computed tomography imaging is essential for establishing the correct diagnosis. Relevant instability of the syndesmosis results from at least two ligament ruptures or avulsion fractures. The objective of surgical treatment is the anatomical reconstruction of the tibial incisura and the correct reduction of the fibula into it. Stable fixation of the ankle mortise is achieved using tibiofibular screws, biodegradable or flexible implants. The most critical prognostic factor after unstable injuries to the distal tibiofibular syndesmosis is the anatomical, stable restoration of the ankle mortise, specifically the correct placement of the distal fibula within the tibial incisura. The reduction and bony fixation of displaced syndesmotic avulsion injuries are instrumental for this.