The distal tibiofibular syndesmosis is a fibrous joint bound by the anterior and posterior inferior tibiofibular ligaments, transverse tibiofibular ligament, and interosseous membrane. Its integrity is critical for ankle mortise stability — disruption allows fibular diastasis that widens the mortise and increases talofibular contact stress. Already covered as syndesmotic-ligaments but worth documenting as a joint.
Syndesmotic injury (high ankle sprain) requires longer rehabilitation (8 to 12 weeks) than lateral ankle sprains (4 to 6 weeks). Diastasis greater than 2 mm on stress radiographs requires surgical stabilisation with syndesmotic screw or suture button device.
High ankle sprain widening the ankle mortise requiring surgical stabilisation for significant diastasis.
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