Die akute ligamentäre Verletzung der Syndesmose — wie behandeln?

Abstract

Recently, a better understanding of the mechanism of injury and treatment of acute syndesmotic injuries has been gained. Surgical treatment is recommended for unstable injuries. In addition to the implantation of fibulotibial positioning screws, dynamic suture button procedures and ligament bracing systems are available.

In recent years, the bony avulsions of the anterior syndesmosis on the ventral edge of the tibia (Tubercúle de Tillaux-Chaput fragment), of the ventral syndesmosis on the fibula (Wagstaffe fragment) and of the posterior syndesmosis (posterior malleolar fragment (PMF)), have become increasingly important, the refixation should be carried out generously. The treatment of additional delta ligament injuries continues to be controversial. The anatomical reconstruction of the ankle joint remains crucial for long-term results and functionality.