Rupture of the tibiofibular syndesmosis without osseous fibular injury.

Ruf W, Friedl P, Frobenius H. Aktuelle Traumatol 1987 Aug;17(4):153-6.

Within 3 years 12 injuries of the anterior fibulo-tibial ligament without fracture of the fibula were recorded prospectively. In relation to the total number of the ankle joint fractures during the same period the incidence is 3.3%. The rupture of the ligament arose in all cases from a forced eversion combined with supination or pronation of the foot. Clinical characteristics are the circumscribed painful palpation of the area of the ligament together with eversion pain of the foot. Arthrography is the most sensitive diagnostic procedure, which, however, may be avoided if the clinical situation is absolutely clear. Differential diagnosis consists mainly in the rupture of the fibulo-talar ligament including a tear of the anterior capsule of the ankle joint. Treatment should always be surgical – suture of the ligament, reinforcement of the syndesmosis by means of a positioning screw. Aftercare is functional without external fixation.