{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:31:09Z","timestamp":1787445069524,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,4,26]],"date-time":"2013-04-26T00:00:00Z","timestamp":1366934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study is to systematically review and meta\u2010analyse the available literature on the treatment of chronic syndesmotic injuries of the ankle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of the PubMed\/MEDLINE and EMBASE databases was conducted in August 2012 utilizing the keywords (treatment OR intervention) AND (injury OR sprain OR rupture) AND (syndesmosis OR syndesmotic OR \u201chigh ankle\u201d OR \u201canterior inferior tibiofibular ligament\u201d OR AITFL OR \u201cposterior inferior tibiofibular ligament\u201d OR PITFL OR tibiofibular diastasis). Studies that reported the outcomes of the surgical treatment of chronic syndesmotic injury were included in our review. Chronic was defined as symptoms longer than 6\u00a0months. Meta\u2010analysis based on random\u2010effects models was performed to pool the rates of success for different treatment methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The search yielded 416 publications from PubMed\/MEDLINE and 473 publications from EMBASE. After abstract and full\u2010text review, 15 articles were included in this review. Treatment methods were placed into three broad surgical treatment categories: screw fixation, arthrodesis and arthroscopic debridement. The most common treatment strategy employed was screw fixation. The pooled rates of success for screw fixation, arthrodesis and arthroscopic debridement were 87.9, 79.4 and 78.7 %, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The current evidence on the treatment of chronic syndesmosis injuries in the ankle is limited to prospective and retrospective case series. The pooled success rates for screw fixation, arthrodesis and arthroscopic debridement each exceeded 78 %. Future high\u2010level studies are required to discern the most appropriate treatment strategy(ies) for chronic syndesmotic injuries of the ankle.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-013-2515-y","type":"journal-article","created":{"date-parts":[[2013,5,1]],"date-time":"2013-05-01T18:35:35Z","timestamp":1367433335000},"page":"1931-1939","source":"Crossref","is-referenced-by-count":41,"title":["Treatment of chronic syndesmotic injury: a systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"21","author":[{"given":"George","family":"Parlamas","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Foot and Ankle Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles P.","family":"Hannon","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Foot and Ankle Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Murawski","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Foot and Ankle Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall A.","family":"Smyth","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Foot and Ankle Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Ma","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Foot and Ankle Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gino M.","family":"Kerkhoffs","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery, Orthopedic Research Center Amsterdam, Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Niek","family":"van Dijk","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery, Orthopedic Research Center Amsterdam, Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Karlsson","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Orthopaedic Surgery Sahlgrenska University Hospital M\u00f6lndal Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Foot and Ankle Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,26]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/000164700317381243"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/17453670510041817"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B4.19750"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197\u20102456(86)90046\u20102"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177729756"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070302400503"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068\u2010006\u20109068\u20104"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0336"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602701218"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070102200103"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100838.1998.tb00227.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0020\u20101383(83)90007\u20104"},{"key":"e_1_2_6_14_2","doi-asserted-by":"crossref","unstructured":"McCollumGA van denBekeromMPJ KerkhoffsGMMJ CalderJDF vanDijkCN(2012)Syndesmosis and deltoid ligament injuries in the athlete.Knee Surg Sports Traumatol Arthrosc [Epub ahead of print]","DOI":"10.1007\/s00167-012-2205-1"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v2.i1.1"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0506"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749\u20108063(05)80015\u20105"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749\u20108063(97)90181\u2010X"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00030"},{"key":"e_1_2_6_20_2","first-page":"611","article-title":"Injuries to the distal tibiofibular syndesmosis: an evidence\u2010based approach to acute and chronic lesions","volume":"13","author":"Rammelt S","year":"2008","journal-title":"FCL"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2008.02.013"},{"key":"e_1_2_6_22_2","doi-asserted-by":"crossref","unstructured":"SmanAD HillerCE RefshaugeKM(2012)Diagnostic accuracy of clinical tests for diagnosis of ankle syndesmosis injury: a systematic review.Brit J Sports Med [Epub ahead of print]","DOI":"10.1136\/bjsports-2012-091702"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654\u2010010\u20109491\u2010z"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.85B3.13174"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u201012\u2010212"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010010\u20101311\u20101"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2008.04.002"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010009\u20100942\u20106"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-013-2515-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00167-013-2515-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-013-2515-y","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T11:10:47Z","timestamp":1760872247000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-013-2515-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,26]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2013,8]]}},"alternative-id":["10.1007\/s00167-013-2515-y"],"URL":"https:\/\/doi.org\/10.1007\/s00167-013-2515-y","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,4,26]]}}}