Syndesmosis injuries: acute, chronic, new techniques for failed management.

A syndesmotic injury occurs through tearing, rupture, or bony avulsion of the syndesmotic ligament complex. The syndesmotic ligament complex consists of the anterior tibiofibular, the posterior tibiofibular, the transverse tibiofibular and the interosseous ligaments. Without these ligamentous restraints the distal tibiofibular joint (DTFJ) widens and can result in an asymmetric ankle mortise. Many cadaveric studies have been performed to evaluate the force required and amount of DTFJ displacement with progressive sectioning of the syndesmotic ligaments.