The instability could result from widening of the ankle mortice following stretching of the ligaments. The distal tibiofibular syndesmosis must be stable and congruent for normal ankle motion under physiological load.
Anatomy Of The Foot And Ankle Orthopaedia
Injuries can occur with any ankle motion but the most common motions are extreme external rotation or dorsiflexion of the talus.

Ankle syndesmosis anatomy. It is reported ankle syndesmosis injury occurs in 1 11 of all ankle sprains without fractures however 40 of patients report ankle instability six months post ankle sprain. Only a few joints in the body are syndesmosis joints. This articulation of the fibula with the tibia can be subdivided further into 3 regions.
They are estimated to comprise 10 range 1 20 of ankle injuries. Anatomy the ankle is a synovial joint composed of the distal tibia and fibula as they articulate with the talus. The syndesmosis of the ankle refers to the membrane connecting the tibia to the fibula.
In addition to the ankle syndesmosis the connection of the tibia and fibula syndesmosis joints are also located in the lower spine where the top of the triangular shaped sacrum bone fits between the pelvis bones. The tibia and fibula are connected throughout their length by an interosseous membrane. Ligaments distal tibiofibular syndesmosis includes anterior inferior tibiofibular ligaments aitfl originates from anterolateral tubercle of tibia chaputs inserts on anterior tubercle of fibula wagstaffes posterior inferior tibiofibular ligament pitfl originates from posterior tubercle of tibia volkmanns inserts on posterior part of.
Anatomy biomechanics mechanism of injury and clinical guidelines for diagnosis and intervention cheng feng lin ms1 michael t. Distal tibiofibular syndesmosis injuries are a relatively frequent ankle injury although less common than a fracture or lateral collateral ligament injuries. The superior or proximal tibiofibular joint the interosseous membrane and the inferior or distal tibiofibular joint.
The distal tibia and fibula articulate with each other at the distal tibiofibular joint which is more commonly referred to as the tibiofibular syndesmosis or simply the syndesmosis. Gross pt phd2 paul weinhold phd3 syndesmosis injuries are rare but very debilitating and frequently misdiagnosed. A syndesmotic or high ankle sprain is one that involves the ligaments binding the distal tibia and fibula at the distal tibiofibular syndesmosis.
A third articulation in the region of the ankle and lower leg is between the tibia and fibula. Syndesmotic injury usually occurred in ankle sprain with external rotation of the talus that resulted at either ligamentous rupture or bony avulsion of the syndesmotic ligament complex. However there are three definable ligaments at the ankle as follows.
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