Review ArticleSyndesmosis Injury From Diagnosis to Repair: Physical Examination, Diagnosis, and Arthroscopic-assisted ReductionWake, Jeffrey DO; Martin, Kevin D. DO, FAAOSAuthor Information From the Brian D. Allgood Army Community Hospital (Dr. Wake), South Korea, and the Evans Army Community Hospital (Dr. Martin), Colorado Springs, CO. Dr. Martin or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of Arthrex speaker and iWalk speaker; serves as a board member, owner, officer, or committee member of AOFAS. Neither Dr. Wake nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article. Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.jaaos.org). Journal of the American Academy of Orthopaedic Surgeons: July 1, 2020 - Volume 28 - Issue 13 - p 517-527 doi: 10.5435/JAAOS-D-19-00358 SDC Metrics Abstract Injuries to the tibio-fibular syndesmotic ligaments are different than ankle collateral ligament injuries and occur in isolation or combination with malleolar fractures. Syndesmotic ligament injury can lead to prolonged functional limitations and ultimately long-term ankle dysfunction if not identified and treated appropriately. The syndesmosis complex is a relatively simple construct of well-documented ligaments, but the dynamic kinematics and the effects of disruption have been a point of contention in diagnosis and treatment. Syndesmotic ligament injuries are sometimes referred to as “high ankle sprains” because the syndesmotic ligaments are more proximal than the collateral ligaments of the ankle joint. Rotational injuries to the ankle often result in malleolar fractures, which can be combined with ankle joint or syndesmotic ligament injuries. Most of the orthopaedic literature to this point has addressed syndesmosis ligament injuries in combination with fractures and not isolated syndesmotic ligament injuries. Thus, we propose a simplified general video guide to do the diagnostic examinations and arthroscopic-assisted reduction based on current evidence-based medicine. Copyright 2020 by the American Academy of Orthopaedic Surgeons.