Injuries to the Ankle Syndesmosis

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Injuries to the Ankle Syndesmosis by Tyler J. Van Heest, and Paul M. Lafferty J Bone Joint Surg Am Volume 96(7):603-613 April 2, 2014 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Drawing of the ligamentous anatomy of the distal tibiofibular syndesmosis with anterior, posterior, lateral, and axial cut views. Drawing of the ligamentous anatomy of the distal tibiofibular syndesmosis with anterior, posterior, lateral, and axial cut views. AITFL = anterior inferior tibiofibular ligament, IOL = interosseous ligament, PITFL = posterior inferior tibiofibular ligament, and ITL = inferior transverse ligament. (Reproduced, with permission, from: Davidovitch RI, Egol KA. Ankle fractures. In: Bucholz RW, Heckman JD, Court-Brown CM, Tornetta P, editors. Rockwood and Green’s fractures in adults. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2010. Figure 57-12.)‏ Tyler J. Van Heest, and Paul M. Lafferty J Bone Joint Surg Am 2014;96:603-613 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Vascular anatomy at the distal tibiofibular syndesmosis, showing the peroneal artery (A) and an anterior branch (B) of the peroneal artery. Vascular anatomy at the distal tibiofibular syndesmosis, showing the peroneal artery (A) and an anterior branch (B) of the peroneal artery. The arrow indicates the posterior branch of the peroneal artery. (Reproduced from: McKeon KE, Wright RW, Johnson JE, McCormick JJ, Klein SE. Vascular anatomy of the tibiofibular syndesmosis. J Bone Joint Surg Am. 2012 May 16;94[10]:931-8.)‏ Tyler J. Van Heest, and Paul M. Lafferty J Bone Joint Surg Am 2014;96:603-613 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Radiographs of ankles with common injury patterns associated with syndesmotic injury (arrows), demonstrating a pronation-external rotation or Weber type-C fracture (Fig. 3-A), a supination-external rotation or Weber type-B fracture (Fig. 3-B), and a Maisonn... Radiographs of ankles with common injury patterns associated with syndesmotic injury (arrows), demonstrating a pronation-external rotation or Weber type-C fracture (Fig. 3-A), a supination-external rotation or Weber type-B fracture (Fig. 3-B), and a Maisonneuve fracture, with an inset showing a typical proximal fibular fracture associated with this injury (Fig. 3-C). Tyler J. Van Heest, and Paul M. Lafferty J Bone Joint Surg Am 2014;96:603-613 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Common radiographic measurements for diagnosing syndesmotic injuries, including tibiofibular overlap (A), tibiofibular clear space (B), and medial clear space (C). Common radiographic measurements for diagnosing syndesmotic injuries, including tibiofibular overlap (A), tibiofibular clear space (B), and medial clear space (C). Tibiofibular overlap and tibiofibular clear space are measured 1 cm proximal to the plafond. Tyler J. Van Heest, and Paul M. Lafferty J Bone Joint Surg Am 2014;96:603-613 ©2014 by The Journal of Bone and Joint Surgery, Inc.