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Acute Syndesmotic Injuries

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Foot and Ankle Sports Orthopaedics

Abstract

Ligamentous ankle injuries remain one of the most common injuries sustained by athletes. Syndesmotic, often termed high ankle, sprains are being diagnosed more frequently due to a heightened awareness and improved diagnostic techniques. These injuries result in pain, disability, and a significant delay in return to play. Most operative syndesmotic injuries can be diagnosed on plain radiographs, including stress views; however, ultrasound, CT, and MRI have improved the detection of more subtle injuries. Arthroscopic evaluation can be used to confirm the diagnosis while assessing other intra-articular structures. There has been an abundance of recent research exploring the treatment of syndesmotic injuries in athletes, focusing on surgical intervention and rehabilitation protocols. The literature remains conflicted regarding return to play in athletes.

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References

  1. Brosky T, Nyland J, Nitz A, Caborn DN. The ankle ligaments: consideration of syndesmotic injury and implications for rehabilitation. J Orthop Sports Phys Ther. 1995;21(4):197–205.

    Article  CAS  PubMed  Google Scholar 

  2. McCollum GA, van den Bekerom MP, Kerkhoffs GM, Calder JD, van Dijk CN. Syndesmosis and deltoid ligament injuries in the athlete. Knee Surg Sports Traumatol Arthrosc. 2013;21(6):1328–37.

    Article  PubMed  Google Scholar 

  3. Fallat L, Grimm DJ, Saracco JA. Sprained ankle syndrome: prevalence and analysis of 639 acute injuries. J Foot Ankle Surg. 1998;37(4):280–5.

    Article  CAS  PubMed  Google Scholar 

  4. Boytim MJ, Fischer DA, Neumann L. Syndesmotic ankle sprains. Am J Sports Med. 1991;19(3):294–8.

    Article  CAS  PubMed  Google Scholar 

  5. Waterman BR, Belmont Jr PJ, Cameron KL, Svoboda SJ, Alitz CJ, Owens BD. Risk factors for syndesmotic and medial ankle sprain: role of sex, sport, and level of competition. Am J Sports Med. 2011;39(5):992–8.

    Article  PubMed  Google Scholar 

  6. Wright RW, Barile RJ, Surprenant DA, Matava MJ. Ankle syndesmosis sprains in national hockey league players. Am J Sports Med. 2004;32(8):1941–5.

    Article  PubMed  Google Scholar 

  7. Jones MH, Amendola A. Syndesmosis sprains of the ankle: a systematic review. Clin Orthop Relat Res. 2007;455:173–5.

    Article  PubMed  Google Scholar 

  8. Gerber JP, Williams GN, Scoville CR, Arciero RA, Taylor DC. Persistent disability associated with ankle sprains: a prospective examination of an athletic population. Foot Ankle Int. 1998;19(10):653–60.

    Article  CAS  PubMed  Google Scholar 

  9. Hopkinson WJ, St Pierre P, Ryan JB, Wheeler JH. Syndesmosis sprains of the ankle. Foot Ankle. 1990;10(6):325–30.

    Article  CAS  PubMed  Google Scholar 

  10. Williams GN, Jones MH, Amendola A. Syndesmotic ankle sprains in athletes. Am J Sports Med. 2007;35(7):1197–207.

    Article  PubMed  Google Scholar 

  11. Bartonicek J. Anatomy of the tibiofibular syndesmosis and its clinical relevance. Surg Radiol Anat. 2003;25(5–6):379–86.

    Article  PubMed  Google Scholar 

  12. Xenos JS, Hopkinson WJ, Mulligan ME, Olson EJ, Popovic NA. The tibiofibular syndesmosis. Evaluation of the ligamentous structures, methods of fixation, and radiographic assessment. J Bone Joint Surg Am. 1995;77(6):847–56.

    Article  CAS  PubMed  Google Scholar 

  13. Close JR. Some applications of the functional anatomy of the ankle joint. J Bone Joint Surg Am. 1956;38-A(4):761–81.

    Article  CAS  PubMed  Google Scholar 

  14. Michelson JD, Helgemo Jr SL. Kinematics of the axially loaded ankle. Foot Ankle Int. 1995;16(9):577–82.

    Article  CAS  PubMed  Google Scholar 

  15. Lundberg A. Kinematics of the ankle and foot. In vivo roentgen stereophotogrammetry. Acta Orthop Scand Suppl. 1989;233:1–24.

    Article  CAS  PubMed  Google Scholar 

  16. Beumer A, van Hemert WL, Niesing R, Entius CA, Ginai AZ, Mulder PG, et al. Radiographic measurement of the distal tibiofibular syndesmosis has limited use. Clin Orthop Relat Res. 2004;423:227–34.

    Article  Google Scholar 

  17. Beumer A, Valstar ER, Garling EH, Niesing R, Ranstam J, Lofvenberg R, et al. Kinematics of the distal tibiofibular syndesmosis: radiostereometry in 11 normal ankles. Acta Orthop Scand. 2003;74(3):337–43.

    Article  PubMed  Google Scholar 

  18. Ramsey PL, Hamilton W. Changes in tibiotalar area of contact caused by lateral talar shift. J Bone Joint Surg Am. 1976;58(3):356–7.

    Article  CAS  PubMed  Google Scholar 

  19. Calhoun JH, Li F, Ledbetter BR, Viegas SF. A comprehensive study of pressure distribution in the ankle joint with inversion and eversion. Foot Ankle Int. 1994;15(3):125–33.

    Article  CAS  PubMed  Google Scholar 

  20. Ogilvie-Harris DJ, Reed SC, Hedman TP. Disruption of the ankle syndesmosis: biomechanical study of the ligamentous restraints. Arthroscopy. 1994;10(5):558–60.

    Article  CAS  PubMed  Google Scholar 

  21. Candal-Couto JJ, Burrow D, Bromage S, Briggs PJ. Instability of the tibio-fibular syndesmosis: have we been pulling in the wrong direction? Injury. 2004;35(8):814–8.

    Article  CAS  PubMed  Google Scholar 

  22. Michelson JD, Waldman B. An axially loaded model of the ankle after pronation external rotation injury. Clin Orthop Relat Res. 1996;328:285–93.

    Article  Google Scholar 

  23. Beumer A, Valstar ER, Garling EH, Niesing R, Ginai AZ, Ranstam J, et al. Effects of ligament sectioning on the kinematics of the distal tibiofibular syndesmosis: a radiostereometric study of 10 cadaveric specimens based on presumed trauma mechanisms with suggestions for treatment. Acta Orthop. 2006;77(3):531–40.

    Article  PubMed  Google Scholar 

  24. Lauge-Hansen N. Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg. 1950;60(5):957–85.

    Article  CAS  PubMed  Google Scholar 

  25. Anderson RB, Hunt KJ, McCormick JJ. Management of common sports-related injuries about the foot and ankle. J Am Acad Orthop Surg. 2010;18(9):546–56.

    Article  PubMed  Google Scholar 

  26. Beumer A, van Hemert WL, Swierstra BA, Jasper LE, Belkoff SM. A biomechanical evaluation of clinical stress tests for syndesmotic ankle instability. Foot Ankle Int. 2003;24(4):358–63.

    Article  PubMed  Google Scholar 

  27. Hunt KJ, George E, Harris AH, Dragoo JL. Epidemiology of syndesmosis injuries in intercollegiate football: incidence and risk factors from National Collegiate Athletic Association injury surveillance system data from 2004–2005 to 2008–2009. Clin J Sport Med. 2013;23(4):278–82.

    Article  PubMed  Google Scholar 

  28. Mak MF, Gartner L, Pearce CJ. Management of syndesmosis injuries in the elite athlete. Foot Ankle Clin. 2013;18(2):195–214.

    Article  PubMed  Google Scholar 

  29. Nussbaum ED, Hosea TM, Sieler SD, Incremona BR, Kessler DE. Prospective evaluation of syndesmotic ankle sprains without diastasis. Am J Sports Med. 2001;29(1):31–5.

    CAS  PubMed  Google Scholar 

  30. van Dijk CN, Mol BW, Lim LS, Marti RK, Bossuyt PM. Diagnosis of ligament rupture of the ankle joint. Physical examination, arthrography, stress radiography and sonography compared in 160 patients after inversion trauma. Acta Orthop Scand. 1996;67(6):566–70.

    Article  PubMed  Google Scholar 

  31. Kiter E, Bozkurt M. The crossed-leg test for examination of ankle syndesmosis injuries. Foot Ankle Int. 2005;26(2):187–8.

    Article  PubMed  Google Scholar 

  32. Beumer A, Swierstra BA, Mulder PG. Clinical diagnosis of syndesmotic ankle instability: evaluation of stress tests behind the curtains. Acta Orthop Scand. 2002;73(6):667–9.

    PubMed  Google Scholar 

  33. de Cesar PC, Avila EM, de Abreu MR. Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain. Foot Ankle Int. 2011;32(12):1110–4.

    Article  PubMed  Google Scholar 

  34. Amendola A, Williams G, Foster D. Evidence-based approach to treatment of acute traumatic syndesmosis (high ankle) sprains. Sports Med Arthrosc. 2006;14(4):232–6.

    Article  PubMed  Google Scholar 

  35. Ebraheim NA, Elgafy H, Padanilam T. Syndesmotic disruption in low fibular fractures associated with deltoid ligament injury. Clin Orthop Relat Res. 2003;409:260–7.

    Article  Google Scholar 

  36. Weening B, Bhandari M. Predictors of functional outcome following transsyndesmotic screw fixation of ankle fractures. J Orthop Trauma. 2005;19(2):102–8.

    Article  PubMed  Google Scholar 

  37. Harper MC, Keller TS. A radiographic evaluation of the tibiofibular syndesmosis. Foot Ankle. 1989;10(3):156–60.

    Article  CAS  PubMed  Google Scholar 

  38. Ostrum RF, De Meo P, Subramanian R. A critical analysis of the anterior-posterior radiographic anatomy of the ankle syndesmosis. Foot Ankle Int. 1995;16(3):128–31.

    Article  CAS  PubMed  Google Scholar 

  39. Beumer A, Valstar ER, Garling EH, van Leeuwen WJ, Sikma W, Niesing R, et al. External rotation stress imaging in syndesmotic injuries of the ankle: comparison of lateral radiography and radiostereometry in a cadaveric model. Acta Orthop Scand. 2003;74(2):201–5.

    Article  PubMed  Google Scholar 

  40. Marmor M, Hansen E, Han HK, Buckley J, Matityahu A. Limitations of standard fluoroscopy in detecting rotational malreduction of the syndesmosis in an ankle fracture model. Foot Ankle Int. 2011;32(6):616–22.

    Article  PubMed  Google Scholar 

  41. Ebraheim NA, Lu J, Yang H, Mekhail AO, Yeasting RA. Radiographic and CT evaluation of tibiofibular syndesmotic diastasis: a cadaver study. Foot Ankle Int. 1997;18(11):693–8.

    Article  CAS  PubMed  Google Scholar 

  42. Sclafani SJ. Ligamentous injury of the lower tibiofibular syndesmosis: radiographic evidence. Radiology. 1985;156(1):21–7.

    Article  CAS  PubMed  Google Scholar 

  43. Muhle C, Frank LR, Rand T, Ahn JM, Yeh LR, Trudell D, et al. Tibiofibular syndesmosis: high-resolution MRI using a local gradient coil. J Comput Assist Tomogr. 1998;22(6):938–44.

    Article  CAS  PubMed  Google Scholar 

  44. Takao M, Ochi M, Oae K, Naito K, Uchio Y. Diagnosis of a tear of the tibiofibular syndesmosis. The role of arthroscopy of the ankle. J Bone Joint Surg Br. 2003;85(3):324–9.

    Article  CAS  PubMed  Google Scholar 

  45. Mei-Dan O, Kots E, Barchilon V, Massarwe S, Nyska M, Mann G. A dynamic ultrasound examination for the diagnosis of ankle syndesmotic injury in professional athletes: a preliminary study. Am J Sports Med. 2009;37(5):1009–16.

    Article  PubMed  Google Scholar 

  46. Brown KW, Morrison WB, Schweitzer ME, Parellada JA, Nothnagel H. MRI findings associated with distal tibiofibular syndesmosis injury. AJR Am J Roentgenol. 2004;182(1):131–6.

    Article  PubMed  Google Scholar 

  47. Hepple S, Guha A. The role of ankle arthroscopy in acute ankle injuries of the athlete. Foot Ankle Clin. 2013;18(2):185–94.

    Article  PubMed  Google Scholar 

  48. Ogilvie-Harris DJ, Gilbart MK, Chorney K. Chronic pain following ankle sprains in athletes: the role of arthroscopic surgery. Arthroscopy. 1997;13(5):564–74.

    Article  CAS  PubMed  Google Scholar 

  49. Edwards Jr GS, DeLee JC. Ankle diastasis without fracture. Foot Ankle. 1984;4(6):305–12.

    Article  PubMed  Google Scholar 

  50. Williams GN, Allen EJ. Rehabilitation of syndesmotic (high) ankle sprains. Sports Health. 2010;2(6):460–70.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Amendola A. Controversies in diagnosis and management of syndesmosis injuries of the ankle. Foot Ankle. 1992;13(1):44–50.

    Article  CAS  PubMed  Google Scholar 

  52. Phisitkul P, Ebinger T, Goetz J, Vaseenon T, Marsh JL. Forceps reduction of the syndesmosis in rotational ankle fractures: a cadaveric study. J Bone Joint Surg Am. 2012;94(24):2256–61.

    Article  PubMed  Google Scholar 

  53. Tornetta 3rd P, Spoo JE, Reynolds FA, Lee C. Overtightening of the ankle syndesmosis: is it really possible? J Bone Joint Surg Am. 2001;83-A(4):489–92.

    Article  PubMed  Google Scholar 

  54. Sagi HC, Shah AR, Sanders RW. The functional consequence of syndesmotic joint malreduction at a minimum 2-year follow-up. J Orthop Trauma. 2012;26(7):439–43.

    Article  PubMed  Google Scholar 

  55. Miller AN, Barei DP, Iaquinto JM, Ledoux WR, Beingessner DM. Iatrogenic syndesmosis malreduction via clamp and screw placement. J Orthop Trauma. 2013;27(2):100–6.

    Article  PubMed  Google Scholar 

  56. Gardner MJ, Demetrakopoulos D, Briggs SM, Helfet DL, Lorich DG. Malreduction of the tibiofibular syndesmosis in ankle fractures. Foot Ankle Int. 2006;27(10):788–92.

    Article  PubMed  Google Scholar 

  57. Miller AN, Carroll EA, Parker RJ, Boraiah S, Helfet DL, Lorich DG. Direct visualization for syndesmotic stabilization of ankle fractures. Foot Ankle Int. 2009;30(5):419–26.

    Article  PubMed  Google Scholar 

  58. Chissell HR, Jones J. The influence of a diastasis screw on the outcome of Weber type-C ankle fractures. J Bone Joint Surg Br. 1995;77(3):435–8.

    CAS  PubMed  Google Scholar 

  59. Hsu AR, Gross CE, Lee S. Intraoperative O-arm computed tomography evaluation of syndesmotic reduction: case report. Foot Ankle Int. 2013;34(5):753–9.

    Article  PubMed  Google Scholar 

  60. Franke J, von Recum J, Suda AJ, Grutzner PA, Wendl K. Intraoperative three-dimensional imaging in the treatment of acute unstable syndesmotic injuries. J Bone Joint Surg Am. 2012;94(15):1386–90.

    Article  PubMed  Google Scholar 

  61. Oae K, Takao M, Naito K, Uchio Y, Kono T, Ishida J, et al. Injury of the tibiofibular syndesmosis: value of MR imaging for diagnosis. Radiology. 2003;227(1):155–61.

    Article  PubMed  Google Scholar 

  62. Loren GJ, Ferkel RD. Arthroscopic assessment of occult intra-articular injury in acute ankle fractures. Arthroscopy. 2002;18(4):412–21.

    Article  PubMed  Google Scholar 

  63. Dijk CN, SpringerLink (Online service). Ankle arthroscopy techniques developed by the Amsterdam Foot and Ankle School. Available from: http://dx.doi.org/10.1007/978-3-642-35989-7.

  64. Ogilvie-Harris DJ, Reed SC. Disruption of the ankle syndesmosis: diagnosis and treatment by arthroscopic surgery. Arthroscopy. 1994;10(5):561–8.

    Article  CAS  PubMed  Google Scholar 

  65. Wolf BR, Amendola A. Syndesmosis injuries in the athlete: when and how to operate. Curr Opin Orthop. 2002;13(2):151–4.

    Article  Google Scholar 

  66. Miller SD. Controversies in ankle fracture treatment. Indications for fixation of stable Weber type B fractures and indications for syndesmosis stabilization. Foot Ankle Clin. 2000;5(4):841–51. vi.

    CAS  PubMed  Google Scholar 

  67. Stufkens SA, van den Bekerom MP, Doornberg JN, van Dijk CN, Kloen P. Evidence-based treatment of maisonneuve fractures. J Foot Ankle Surg. 2011;50(1):62–7.

    Article  PubMed  Google Scholar 

  68. Yamaguchi K, Martin CH, Boden SD, Labropoulos PA. Operative treatment of syndesmotic disruptions without use of a syndesmotic screw: a prospective clinical study. Foot Ankle Int. 1994;15(8):407–14.

    Article  CAS  PubMed  Google Scholar 

  69. Boden SD, Labropoulos PA, McCowin P, Lestini WF, Hurwitz SR. Mechanical considerations for the syndesmosis screw. A cadaver study. J Bone Joint Surg Am. 1989;71(10):1548–55.

    Article  CAS  PubMed  Google Scholar 

  70. Taylor DC, Tenuta JJ, Uhorchak JM, Arciero RA. Aggressive surgical treatment and early return to sports in athletes with grade III syndesmosis sprains. Am J Sports Med. 2007;35(11):1833–8.

    Article  PubMed  Google Scholar 

  71. Kukreti S, Faraj A, Miles JN. Does position of syndesmotic screw affect functional and radiological outcome in ankle fractures? Injury. 2005;36(9):1121–4.

    Article  CAS  PubMed  Google Scholar 

  72. McBryde A, Chiasson B, Wilhelm A, Donovan F, Ray T, Bacilla P. Syndesmotic screw placement: a biomechanical analysis. Foot Ankle Int. 1997;18(5):262–6.

    Article  CAS  PubMed  Google Scholar 

  73. Markolf KL, Jackson SR, McAllister DR. Syndesmosis fixation using dual 3.5 mm and 4.5 mm screws with tricortical and quadricortical purchase: a biomechanical study. Foot Ankle Int. 2013;34(5):734–9.

    Article  PubMed  Google Scholar 

  74. Hansen M, Le L, Wertheimer S, Meyer E, Haut R. Syndesmosis fixation: analysis of shear stress via axial load on 3.5-mm and 4.5-mm quadricortical syndesmotic screws. J Foot Ankle Surg. 2006;45(2):65–9.

    Article  PubMed  Google Scholar 

  75. Thompson MC, Gesink DS. Biomechanical comparison of syndesmosis fixation with 3.5- and 4.5-millimeter stainless steel screws. Foot Ankle Int. 2000;21(9):736–41.

    Article  CAS  PubMed  Google Scholar 

  76. Hoiness P, Stromsoe K. Tricortical versus quadricortical syndesmosis fixation in ankle fractures: a prospective, randomized study comparing two methods of syndesmosis fixation. J Orthop Trauma. 2004;18(6):331–7.

    Article  PubMed  Google Scholar 

  77. Thordarson DB, Samuelson M, Shepherd LE, Merkle PF, Lee J. Bioabsorbable versus stainless steel screw fixation of the syndesmosis in pronation-lateral rotation ankle fractures: a prospective randomized trial. Foot Ankle Int. 2001;22(4):335–8.

    Article  CAS  PubMed  Google Scholar 

  78. Bostman OM, Pihlajamaki HK. Late foreign-body reaction to an intraosseous bioabsorbable polylactic acid screw. A case report. J Bone Joint Surg Am. 1998;80(12):1791–4.

    Article  CAS  PubMed  Google Scholar 

  79. Clanton TO, Matheny LM, Jarvis HC, Lewis EV, Ambrose CG. Quantitative analysis of torsional stiffness in supplemental one-third tubular plate fixation in the management of isolated syndesmosis injuries: a biomechanical study. Foot Ankle Int. 2013;34(2):267–72.

    Article  PubMed  Google Scholar 

  80. Seitz Jr WH, Bachner EJ, Abram LJ, Postak P, Polando G, Brooks DB, et al. Repair of the tibiofibular syndesmosis with a flexible implant. J Orthop Trauma. 1991;5(1):78–82.

    Article  PubMed  Google Scholar 

  81. Thornes B, Walsh A, Hislop M, Murray P, O'Brien M. Suture-endobutton fixation of ankle tibio-fibular diastasis: a cadaver study. Foot Ankle Int. 2003;24(2):142–6.

    Article  PubMed  Google Scholar 

  82. Willmott HJ, Singh B, David LA. Outcome and complications of treatment of ankle diastasis with tightrope fixation. Injury. 2009;40(11):1204–6.

    Article  CAS  PubMed  Google Scholar 

  83. Storey P, Gadd RJ, Blundell C, Davies MB. Complications of suture button ankle syndesmosis stabilization with modifications of surgical technique. Foot Ankle Int. 2012;33(9):717–21.

    Article  PubMed  Google Scholar 

  84. Soin SP, Knight TA, Dinah AF, Mears SC, Swierstra BA, Belkoff SM. Suture-button versus screw fixation in a syndesmosis rupture model: a biomechanical comparison. Foot Ankle Int. 2009;30(4):346–52.

    Article  PubMed  Google Scholar 

  85. Teramoto A, Suzuki D, Kamiya T, Chikenji T, Watanabe K, Yamashita T. Comparison of different fixation methods of the suture-button implant for tibiofibular syndesmosis injuries. Am J Sports Med. 2011;39(10):2226–32.

    Article  PubMed  Google Scholar 

  86. Westermann RW, Rungprai C, Goetz JE, Femino J, Amendola A, Phisitkul P. The effect of suture-button fixation on simulated syndesmotic malreduction: a cadaveric study. J Bone Joint Surg Am. 2014;96(20):1732–8.

    Article  PubMed  Google Scholar 

  87. Naqvi GA, Cunningham P, Lynch B, Galvin R, Awan N. Fixation of ankle syndesmotic injuries: comparison of tightrope fixation and syndesmotic screw fixation for accuracy of syndesmotic reduction. Am J Sports Med. 2012;40(12):2828–35.

    Article  PubMed  Google Scholar 

  88. Laflamme M, Belzile EL, Bedard L, van den Bekerom MP, Glazebrook M, Pelet S. A prospective randomized multicenter trial comparing clinical outcomes of patients treated surgically with a static or dynamic implant for acute ankle syndesmosis rupture. J Orthop Trauma. 2014;29(5):216–23.

    Article  Google Scholar 

  89. Moore Jr JA, Shank JR, Morgan SJ, Smith WR. Syndesmosis fixation: a comparison of three and four cortices of screw fixation without hardware removal. Foot Ankle Int. 2006;27(8):567–72.

    Article  PubMed  Google Scholar 

  90. Hamid N, Loeffler BJ, Braddy W, Kellam JF, Cohen BE, Bosse MJ. Outcome after fixation of ankle fractures with an injury to the syndesmosis: the effect of the syndesmosis screw. J Bone Joint Surg Br. 2009;91(8):1069–73.

    Article  CAS  PubMed  Google Scholar 

  91. Song DJ, Lanzi JT, Groth AT, Drake M, Orchowski JR, Shaha SH, et al. The effect of syndesmosis screw removal on the reduction of the distal tibiofibular joint: a Prospective Radiographic Study. Foot Ankle Int. 2014;35(6):543–8.

    Article  PubMed  Google Scholar 

  92. Schepers T. To retain or remove the syndesmotic screw: a review of literature. Arch Orthop Trauma Surg. 2011;131(7):879–83.

    Article  CAS  PubMed  Google Scholar 

  93. Cottom JM, Hyer CF, Philbin TM, Berlet GC. Treatment of syndesmotic disruptions with the Arthrex Tightrope: a report of 25 cases. Foot Ankle Int. 2008;29(8):773–80.

    Article  PubMed  Google Scholar 

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Lareau, C.R., Hsu, A.R., Cohen, B.E. (2016). Acute Syndesmotic Injuries. In: Valderrabano, V., Easley, M. (eds) Foot and Ankle Sports Orthopaedics. Springer, Cham. https://doi.org/10.1007/978-3-319-15735-1_29

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