Ankle syndesmotic injury


High ankle or syndesmotic injuries occur in an "intercalary" manner with rupture of ligaments in order:

  • anterior inferior tibiofibular ligament
  • interosseous membrane
  • posterior inferior tibiofibular ligament

In intermediate injuries (i.e. incomplete rupture of all above structures), the x-ray may be normal and thus a normal x-ray does not exclude a high ankle injury.