T. Brosky et al., THE ANKLE LIGAMENTS - CONSIDERATION OF SYNDESMOTIC INJURY AND IMPLICATIONS FOR REHABILITATION, The Journal of orthopaedic and sports physical therapy, 21(4), 1995, pp. 197-205
Injury to the distal tibiofibular syndesmosis (DTFS) may be more commo
n than previously reported. This injury is typically caused by externa
l forces which produce sudden ankle dorsiflexion or plantar flexion in
combination with external rotation of the foot Common mechanisms incl
ude direct contact with another player or uneven physical terrain. Imp
roper diagnosis oi this injury may greatly delay the return to normal
functional status and promote the development oi chronic instability,
degenerative joint changes, and pain. The purpose oi this clinical com
mentary is to review the ligamentous anatomy of the ankle and the inci
dence oi injury to the lateral ligaments of the ankle, with emphasis o
n DTFS injury. Special tests which enhance the recognition of DTFS inj
ury, such as the external rotation stress test and the distal tibiofib
ular compression test, and a rehabilitation progression are presented.