Old syndesmosis injury


Description of patient (type of occupation, indication of age, intensity of sport):

A 30 years old active female.

History and previous treatment:

Trimalleolar fracture 6 month back, treated with ORIF , 6 weeks after initial surgery screw holding poterior tibial margin and syndesmotic screw removed.

Current complaints:

Hindfoot valgus , ankle pain - deep ans syndesmotic squizze test painfull ++.

Physical examination:

Hindfood valgus , deep ankle pain , ROM 30 plantar , 20 dorsal.


[Picture 1]

Additional investigation (CT/MRI):
[Picture 2]

CT done - Tillaux fragnet fractured nonunited blocking groove for fibula , screw holding posterior margin was actually in syndesmosis.


Case summary:

Old syndesmotic injury with painful ankle

Question(s) to this case:

Best operative treatment solution , any advantage from anterior ankle artroscopy?


Advice is to reconstruct the posterior fragment which is non-united. This can be done through a posterolateral open approach.