Tibiofibular Synostosis M24.673 718.57

Ankle syndesmosis image

Ankle lateral ligaments image

Ankle Cross section image

synonyms:tibiofibular ankylosis,

Tibiofibular Synostosis ICD-10

Tibiofibular Synostosis ICD-9

  • 718.57 (ankylosis of joint; ankle and foot)

Tibiofibular Synostosis Etiology / Epidemiology / Natural History

  • Generally develops after an eversion (high) ankle sprain with disruption of the interosseous membrane.
  • Occurs 6-12 months after ankle sprain.

Tibiofibular Synostosis Anatomy

  • Distal tibiofibular syndesmosisconsists of: AITFL, IOL, interosseous membrane, PITFL, and ITL.
  • AITFL= anterior-inferior tibiofibular ligament: Originate = anterolateral (Chaput’s) tubercle of the tibia. Insertion: anterior (Wagstaffe’s) tubercle of the fibula.
  • IOL= interosseous ligament: thickened distal part of the interosseous membrane.
  • Interosseous membrane,
  • PITFL= posterior-inferior tibiofibular ligament. Origin: the posterior (Volkmann’s) tubercle of the tibia. Insertion: the posterior part of the lateral malleolus.
  • ITL = inferior transverse ligament: fibrocartilaginous distal portion of the PITFL.

Tibiofibular Synostosis Clinical Evaluation

  • Limited ankle dorsiflexion. +/- ankle pain.

Tibiofibular Synostosis Xray / Diagnositc Tests

  • A/P, Lateral and Mortise ankle rays and AP, lateral views of the entire length of the tibia and fibula. Demonstrate bone growth in the area of the Distal tibiofibular syndesmosis.
  • Bone scan: indicated if considering surgical excision. Bone scan should demonstrate ossification is complete (no uptake) before surgical excision.

Tibiofibular Synostosis Classification / Treatment

  • May return to sport with no limitations if pain free.
  • Surgical excision: indicated only in patients with persistent pain.

Tibiofibular Synostosis Associated Injuries / Differential Diagnosis

Tibiofibular Synostosis Complications

Tibiofibular Synostosis Follow-up Care

Tibiofibular Synostosis Review References