Unstable syndesmosis injuries represent an indication for surgical treatment. The principle of surgical treatment of syndesmosis injuries is to prevent diastasis of the fibula and tibia with an implant after repositioning (internal ligament bracing). In the case of implants the new flexible cord fixation represents an increasingly used and safe alternative to rigid screw fixation in recent years. This is a reproducible surgical technique in which diastasis of the fibula and tibia is prevented by a strong suture cord, which is fixed to the cortex of the tibia and fibula via a toggle anchor and button. The suture-button construct is inserted minimally invasively under image intensifier control. The lower rigidity of this fixation method allows micromovements that have a beneficial effect on the healing of the injured syndesmosis ligaments. The results published so far show with high evidence that suture cord treatment is superior to screw fixation in terms of clinical scores, repositioning and reoperation rates, both in isolated unstable syndesmosis injuries and in combination with fibula fractures. Another advantage of this surgical technique is that in most cases it is not necessary to remove the implant. Disadvantages of this procedure, however, are the high implant costs.     «

Unstable syndesmosis injuries represent an indication for surgical treatment. The principle of surgical treatment of syndesmosis injuries is to prevent diastasis of the fibula and tibia with an implant after repositioning (internal ligament bracing). In the case of implants the new flexible cord fixation represents an increasingly used and safe alternative to rigid screw fixation in recent years. This is a reproducible surgical technique in which diastasis of the fibula and tibia is prevented by...     »