SPECIAL FOCUS: Foot and AnkleInjuries of the distal lower extremity syndesmosisBauer, Andrea Sa; Bluman, Eric Mb; Wilson, Michael Ga; Chiodo, Christopher PaAuthor Information aDepartment of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA bMadigan Army Medical Center, Tacoma, WA, USA Correspondence to Christopher P. Chiodo, MD, Brigham Foot & Ankle Center at Faulkner Hospital, 1153 Centre Street, Boston, MA 02130, USA Tel: +617 983 7202; fax: +; e-mail: [email protected] Current Orthopaedic Practice: April 2009 - Volume 20 - Issue 2 - p 111-116 doi: 10.1097/BCO.0b013e31819b04eb Buy Metrics Abstract Injuries to the distal tibiofibular syndesmosis are common and can lead to prolonged disability. The diagnosis of these injuries is not always straightforward. The recent literature has examined the use of plain radiographs, MRI, arthroscopy and intraoperative fluoroscopy in the diagnosis of these injuries. Displaced injuries of the syndesmosis require operative fixation, which can be accomplished in several different ways. Current practice includes fixation with metal screws, bioabsorbable screws and suture-button constructs. Fixation must be preceded by anatomic reduction of the syndesmosis to ensure satisfactory outcome. Chronic injuries to the syndesmosis can be particularly difficult to treat. One method involving surgical synostosis of the distal tibiofibular joint is presented here. © 2009 Lippincott Williams & Wilkins, Inc.