Distal tibiofibular syndesmosis

Last revised by David Luong on 19 Feb 2023

The tibiofibular syndesmosis is a complex fibrous joint composed of multiple ligaments and a broad fibrous interosseous membrane that spans between the tibia and fibula throughout the length of both bones. It is an important structure for ankle stability 1.

Gross anatomy

The distal osseous part of this syndesmotic joint includes the following four components:

Related pathology

  • distal tibiofibular syndesmotic injury: ~5% (range 1-11%) of all ankle injuries involve the distal tibiofibular syndesmosis, which may lead to chronic instability and pain

  • Weber ankle fractures: syndesmotic injuries occur in approximately 50% of Weber B fractures, and in all of Weber C fractures. It does not occur in Weber A fractures as the fracture is below the level of the tibiofibular syndesmosis 1

  • Maisonneuve Fracture

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