Tibiofibular diastasis without ankle fracture:​ a review and report of two cases

Rose, Jonathan D.; Flanigan, K. Paul; Mlodzienski, Alan

Affiliations

¹Department of Podiatric Surgery, Presbyterian Medical Center — University of Pennsylvania Health System, Philadelphia, PA.

Abstract and keywords

Diastasis of the distal tibiofibular syndesmosis is commonly seen with ankle fractures, but is a rare finding in the absence of fracture. The anatomy, biomechanics, mechanism of injury, evaluation, and radiographic assessment of the tibiofibular syndesmosis are reviewed. The authors present a review and two cases of traumatic ankle diastasis without ankle fracture.

Keywords: ankle; ankle dislocation; ankle instability; syndesmosis; tibiofibular diastasis

Links

DOI: 10.1016/S1067-2516(02)80009-6

PubMed: 11858606

History

Received: 2000-10-10

Accepted: 2001-10-17

Online: 2009-02-24

Cited Works (30)

Year	Entry
1993	Sarrafian SK. Anatomy of the Foot and Ankle: Descriptive, Topographic, Functional. 2nd ed. Philadelphia: J. B. Lippincott Company; 1993.
1971	Olerud S. Subluxation of the ankle without fracture of the fibula: a case report. J Bone Joint Surg. April 1971;51A(3):594-596.
1939	Wilson MJ, Michele AA, Jacobson EW. Ankle dislocations without fracture. J Bone Joint Surg. January 1939;21A(1):198-204.
1995	Brosky T, Nyland j, Nitz A, Caborn DNM. The ankle ligaments: consideration of syndesmotic injury and implications for rehabilitation. J Orthop Sports Phys Ther. April 1995;21(4):197-205.
1984	Skraba JS, Greenwald AS. The role of the interosseous membrane on tibiofibular weightbearing. Foot Ankle. May 1984;4(5):301-304.
1985	Sclafani SJA. Ligamentous injury of the lower tibiofibular syndesmosis: radiographic evidence. Radiology. July 1985;156(1):21-27.
1984	Edwards GS Jr, DeLee JC. Ankle diastasis without fracture. Foot Ankle. May–June 1984;4(6):305-312.
1922	Ashhurst APC, Bromer RS. Classification and mechanism of fractures of the leg bones involving the ankle: based on a study of three hundred cases from the Episcopal Hospital. Arch Surg. January 1922;4(1):51-129.
1995	Xenos JS, Hopkinson WJ, Mulligan ME, Olson EJ, Popovic NA. The tibiofibular syndesmosis: evaluation of the ligamentous structures, methods of fixation, and radiographic assessment. J Bone Joint Surg. June 1995;77A(6):847-856.
1998	Alonso A, Khoury L, Adams R. Clinical tests for ankle syndesmosis injury: reliability and prediction of return to function. J Orthop Sports Phys Ther. April 1998;27(4):276-284.
1992	Taylor DC, Englehardt DL, Bassett FH III. Syndesmosis sprains of the ankle: the influence of heterotopic ossification. Am J Sports Med. March 1992;20(2):146-150.
1995	Ostrum RF, De Meo P, Subramanian R. A critical analysis of the anterior-posterior radiographic anatomy of the ankle syndesmosis. Foot Ankle Int. March 1995;16(3):128-131.
1984	Leeds HC, Ehrlich MG. Instability of the distal tibiofibular syndesmosis after bimalleolar and trimalleolar ankle fractures. J Bone Joint Surg. April 1984;66A(4):490-503.
1983	Pettrone FA, Gail M, Pee D, Fitzpatrick T, van Herpe LB. Quantitative criteria for prediction of the results after displaced fracture of the ankle. J Bone Joint Surg. June 1983;65A(5):667-677.
1994	Ogilvie-Harris DJ, Reed SC, Hedman TP. Disruption of the ankle syndesmosis: biomechanical study of the ligamentous restraints. Arthroscopy. October 1994;10(5):558-560.
1976	Scranton PE Jr, McMaster JH, Kelly E. Dynamic fibular function: a new concept. Clin Orthop Relat Res. July–August 1976;118:76-81.
1968	Lovell ES. An unusual rotatory injury of the ankle. J Bone Joint Surg. January 1968;50A(1):163-165.
1995	Miller CD, Shelton WR, Barrett GR, Savoie FH, Dukes AD. Deltoid and syndesmosis ligament injury of the ankle without fracture. Am J Sports Med. December 1995;23(6):746-750.
1982	Rasmussen O, Tovborg-Jensen I, Boe S. Distal tibiofibular ligaments: analysis of function. Acta Orthop Scand. August 1982;53(4):681-686.
1998	Teitz CC, Harrington RM. A biochemical analysis of the squeeze test for sprains of the syndesmotic ligaments of the ankle. Foot Ankle Int. July 1998;19(7):489-492.
1956	Close JR. Some applications of the functional anatomy of the ankle joint. J Bone Joint Surg. July 1956;38A(4):761-781.
1994	Ward DW. Syndesmotic ankle sprain in a recreational hockey player. J Manip Physiol Ther. July–August 1994;17(6):384-394.
1991	Boytim MJ, Fischer DA, Neumann L. Syndesmotic ankle sprains. Am J Sports Med. 1991;19(3):294-298.
1990	Hopkinson WJ, St Pierre P, Ryan JB, Wheeler JH. Syndesmosis sprains of the ankle. Foot Ankle. June 1990;10(6):325-330.
1990	Stiehl JB. Complex ankle fracture dislocations with syndesmotic diastasis. Orthop Rev. June 1990;19(6):499-507.
1948	Lauge N. Fractures of the ankle: analytic historic survey as the basis of new experimental, roentgenologic and clinical investigations. Arch Surg. March 1948;56(3):259-317.
1997	Thordarson DB, Hedman TP, Gross D, Magre G. Biomechanical evaluation of polylactide absorbable screws used for syndesmosis injury repair. Foot Ankle Int. October 1997;18(10):622-627.
1950	Lauge-Hansen N. Fractures of the ankle, II: combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg. 1950;60(5):957-985.
1974	Joy G, Patzakis MJ, Harvey JP Jr. Precise evaluation of the reduction of severe ankle fractures: technique and correlation with end results. J Bone Joint Surg. July 1974;56A(5):979-993.
1952	Lauge-Hansen N. Fractures of the ankle, IV: clinical use of genetic roentgen diagnosis and genetic reduction. Arch Surg. 1952;64(4):488-500.

Cited By (2)

Year	Entry
2011	Soomekh DJ. New technology and techniques in the treatment of foot and ankle injuries. Clin Podiatr Med Surg. 2011;28(1):19-41.
2017	Mait AR. Syndesmotic Ankle Sprains in Large Males [Master's thesis]. Charlottesville, VA: University of Virginia; August 2017.