What Is Syndesmosis Repair?
Syndesmosis repair is a surgical procedure used to treat injuries to the syndesmosis-a fibrous joint between the tibia and fibula just above the ankle. This area can be injured in high ankle sprains or severe ankle fractures, causing instability and pain. The surgery stabilizes the joint to promote proper healing and restore ankle function.
When Is Syndesmosis Repair Recommended?
Syndesmosis repair is generally recommended when conservative treatment fails or in cases of instability. Common indications include:
- High ankle sprains with significant separation between the tibia and fibula
- Ankle fractures involving syndesmotic injury
- Chronic instability or pain after previous ankle trauma
- Failure of non-surgical treatment to restore joint alignment
- Professional athletes or active individuals needing reliable joint stability
How Is Syndesmosis Repair Performed?
The surgery is performed under anesthesia. The surgeon makes a small incision over the ankle to access the joint. Depending on the injury, the tibia and fibula are realigned, and stabilization is achieved using one or more of the following: screws, suture buttons (tightrope system), or a combination. These implants hold the bones together while the ligament heals.
Recovery After Syndesmosis Repair
Patients are typically non-weight-bearing for 4–6 weeks, followed by gradual weight-bearing and physical therapy. Full recovery may take 3–6 months, depending on the severity of the injury and surgical method used. Return to sports can be expected after strength and stability are restored.
Risks of Syndesmosis Repair
While generally safe, risks include:
- Infection
- Nerve or vessel injury
- Implant failure or need for removal
- Delayed healing or nonunion
- Persistent stiffness or instability
Benefits of Syndesmosis Repair
The procedure offers significant advantages:
- Restores ankle stability
- Allows proper joint alignment
- Promotes long-term function
- Reduces pain and risk of arthritis
