{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T10:53:01Z","timestamp":1783680781024,"version":"3.55.0"},"reference-count":47,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"vor","delay-in-days":365,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedics & Traumatology: Surgery & Research"],"published-print":{"date-parts":[[2021,2]]},"DOI":"10.1016\/j.otsr.2020.102778","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T07:46:38Z","timestamp":1608104798000},"page":"102778","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":39,"special_numbering":"S","title":["Traumatic injuries of the distal tibiofibular syndesmosis"],"prefix":"10.1016","volume":"107","author":[{"given":"Olivier","family":"Cornu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Manon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Tribak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Putineanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.otsr.2020.102778_bib0240","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s00068-014-0466-8","article-title":"An update on the evaluation and treatment of syndesmotic injuries","volume":"41","author":"Rammelt","year":"2015","journal-title":"Eur J Trauma Emerg Surg"},{"key":"10.1016\/j.otsr.2020.102778_bib0245","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1097\/BOT.0b013e31822a526a","article-title":"The functional consequence of syndesmotic joint malreduction at a minimum 2-year follow-up","volume":"26","author":"Sagi","year":"2012","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2020.102778_bib0250","doi-asserted-by":"crossref","first-page":"S275","DOI":"10.1016\/j.otsr.2019.09.014","article-title":"Diagnosis and treatment of tobiofibular syndesmosis lesions","volume":"105","author":"Tourne","year":"2019","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2020.102778_bib0255","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.3113\/FAI.2011.1110","article-title":"Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain","volume":"32","author":"de Cesar","year":"2011","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.otsr.2020.102778_bib0260","series-title":"Les fractures mal\u00e9ollaires. Th\u00e9orie et pratique de l\u2019ost\u00e9osynth\u00e8se","first-page":"133","author":"Danis","year":"1949"},{"key":"10.1016\/j.otsr.2020.102778_bib0265","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.2106\/JBJS.J.01287","article-title":"Intraoperative assessment of the stability of the distal tibiofibular joint in supination-external rotation injuries of the ankle: sensitivity, specificity, and reliability of two clinical tests","volume":"93","author":"Pakarinen","year":"2011","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.otsr.2020.102778_bib0270","first-page":"544","article-title":"Ligamentous ankle fractures; diagnosis and treatment","volume":"97","author":"Lauge-Hansen","year":"1949","journal-title":"Acta Chir Scand"},{"key":"10.1016\/j.otsr.2020.102778_bib0275","doi-asserted-by":"crossref","first-page":"e123","DOI":"10.1097\/BOT.0000000000000010","article-title":"Comparison of radiographic stress tests for syndesmotic instability of supination-external rotation ankle fractures: a cadaveric study","volume":"28","author":"Jiang","year":"2014","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2020.102778_bib0280","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s11999-009-0823-9","article-title":"Syndesmotic stabilization in pronation external rotation ankle fractures","volume":"468","author":"van den Bekerom","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.otsr.2020.102778_bib0285","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1053\/j.jfas.2007.08.009","article-title":"Which ankle fractures require syndesmotic stabilization?","volume":"46","author":"van den Bekerom","year":"2007","journal-title":"J Foot Ankle Surg"},{"key":"10.1016\/j.otsr.2020.102778_bib0290","first-page":"e5","article-title":"Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm","volume":"4","author":"Polzer","year":"2012","journal-title":"Orthop Rev (Pavia)"},{"key":"10.1016\/j.otsr.2020.102778_bib0295","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1177\/107110078901000308","article-title":"A radiographic evaluation of the tibiofibular syndesmosis","volume":"10","author":"Harper","year":"1989","journal-title":"Foot Ankle"},{"key":"10.1016\/j.otsr.2020.102778_bib0300","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1177\/107110070202300205","article-title":"The effects of rotation on radiographic evaluation of the tibiofibular syndesmosis","volume":"23","author":"Pneumaticos","year":"2002","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.otsr.2020.102778_bib0305","doi-asserted-by":"crossref","first-page":"870","DOI":"10.3113\/FAI.2012.0870","article-title":"Radiographic evaluation of the normal distal tibiofibular syndesmosis","volume":"33","author":"Shah","year":"2012","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.otsr.2020.102778_bib0310","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1302\/0301-620X.85B3.13174","article-title":"Diagnosis of a tear of the tibiofibular syndesmosis. The role of arthroscopy of the ankle","volume":"85","author":"Takao","year":"2003","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.otsr.2020.102778_bib0315","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1302\/0301-620X.89B8.19134","article-title":"The use of gravity or manual-stress radiographs in the assessment of supination-external rotation fractures of the ankle","volume":"89","author":"Schock","year":"2007","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.otsr.2020.102778_bib0320","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1177\/107110070302400410","article-title":"A biomechanical evaluation of clinical stress tests for syndesmotic ankle instability","volume":"24","author":"Beumer","year":"2003","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.otsr.2020.102778_bib0325","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1002\/jum.14716","article-title":"Normal and injured ankle ligaments on ultrasonography with magnetic resonance imaging correlation","volume":"38","author":"Alves","year":"2019","journal-title":"J Ultrasound Med"},{"key":"10.1016\/j.otsr.2020.102778_bib0330","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.fas.2016.04.001","article-title":"Acute syndesmotic instability in ankle fractures: a review","volume":"23","author":"van Zuuren","year":"2017","journal-title":"Foot Ankle Surg"},{"key":"10.1016\/j.otsr.2020.102778_bib0335","doi-asserted-by":"crossref","first-page":"2646","DOI":"10.2106\/JBJS.G.01537","article-title":"Comparison of two intraoperative assessment methods for injuries to the ankle syndesmosis. A cadaveric study","volume":"91","author":"Stoffel","year":"2009","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.otsr.2020.102778_bib0340","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1177\/1071100714551788","article-title":"Effect of syndesmosis injury in SER IV (Weber B)-type ankle fractures on function and incidence of osteoarthritis","volume":"36","author":"Kortekangas","year":"2015","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.otsr.2020.102778_bib0345","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.ocl.2019.02.004","article-title":"Anatomic ligament repairs of syndesmotic injuries","volume":"50","author":"Akoh","year":"2019","journal-title":"Orthop Clin North Am"},{"key":"10.1016\/j.otsr.2020.102778_bib0350","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/BOT.0b013e31826623cc","article-title":"APTF: anteroposterior tibiofibular ratio, a new reliable measure to assess syndesmotic reduction","volume":"27","author":"Grenier","year":"2013","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2020.102778_bib0355","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/BOT.0b013e31825197cb","article-title":"Iatrogenic syndesmosis malreduction via clamp and screw placement","volume":"27","author":"Miller","year":"2013","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2020.102778_bib0360","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1177\/107110070002100904","article-title":"Biomechanical comparison of syndesmosis fixation with 3.5- and 4.5-millimeter stainless steel screws","volume":"21","author":"Thompson","year":"2000","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.otsr.2020.102778_bib0365","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1053\/j.jfas.2005.12.004","article-title":"Syndesmosis fixation: analysis of shear stress via axial load on 3.5-mm and 4.5-mm quadricortical syndesmotic screws","volume":"45","author":"Hansen","year":"2006","journal-title":"J Foot Ankle Surg"},{"key":"10.1016\/j.otsr.2020.102778_bib0370","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1177\/1071100713510913","article-title":"Risk factors for posttraumatic synostosis and outcomes following operative treatment of ankle fractures","volume":"35","author":"Hinds","year":"2014","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.otsr.2020.102778_bib0375","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1177\/107110070302400503","article-title":"Peroneus longus ligamentoplasty for chronic instability of the distal tibiofibular syndesmosis","volume":"24","author":"Grass","year":"2003","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.otsr.2020.102778_bib0380","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.fcl.2008.08.001","article-title":"Injuries to the distal tibiofibular syndesmosis: an evidence-based approach to acute and chronic lesions","volume":"13","author":"Rammelt","year":"2008","journal-title":"Foot Ankle Clin"},{"key":"10.1016\/j.otsr.2020.102778_bib0385","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/BOT.0b013e31825cfac2","article-title":"Stabilization of the syndesmosis in the Maisonneuve fracture\u00a0\u2013\u00a0a biomechanical study comparing 2-hole locking plate and quadricortical screw fixation","volume":"27","author":"Gardner","year":"2013","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2020.102778_bib0390","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1007\/s00113-018-0508-5","article-title":"Syndesmosis injuries at the ankle","volume":"121","author":"Rammelt","year":"2018","journal-title":"Unfallchirurg"},{"key":"10.1016\/j.otsr.2020.102778_bib0395","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1097\/BOT.0b013e3181bedca1","article-title":"No difference in functional and radiographic results 8.4 years after quadricortical compared with tricortical syndesmosis fixation in ankle fractures","volume":"24","author":"Wikeroy","year":"2010","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2020.102778_bib0400","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.fas.2011.11.003","article-title":"Motion of the fibula relative to the tibia and its alterations with syndesmosis screws: a cadaver study","volume":"18","author":"Huber","year":"2012","journal-title":"Foot Ankle Surg"},{"key":"10.1016\/j.otsr.2020.102778_bib0405","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1007\/s00402-010-1225-x","article-title":"To retain or remove the syndesmotic screw: a review of literature","volume":"131","author":"Schepers","year":"2011","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.otsr.2020.102778_bib0410","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/BOT.0b013e3181a9f7a5","article-title":"Functional and radiographic results of patients with syndesmotic screw fixation: implications for screw removal","volume":"24","author":"Manjoo","year":"2010","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.otsr.2020.102778_bib0415","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1177\/1071100714524552","article-title":"The effect of syndesmosis screw removal on the reduction of the distal tibiofibular joint: a prospective radiographic study","volume":"35","author":"Song","year":"2014","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.otsr.2020.102778_bib0420","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1302\/0301-620X.91B8.22430","article-title":"Outcome after fixation of ankle fractures with an injury to the syndesmosis: the effect of the syndesmosis screw","volume":"91","author":"Hamid","year":"2009","journal-title":"J Bone Joint Surg Br"},{"key":"10.1016\/j.otsr.2020.102778_bib0425","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/j.otsr.2018.07.004","article-title":"Erratum to \u201cTibiofemoral syndesmosis injury treated by temporary screw fixation and ligament repair\u201d [","volume":"104","author":"Steinmetz","year":"2018","journal-title":"Orthop Traumatol Surg Res"},{"key":"10.1016\/j.otsr.2020.102778_bib0430","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s00264-013-2168-y","article-title":"A comprehensive analysis of patients with malreduced ankle fractures undergoing re-operation","volume":"38","author":"Ovaska","year":"2014","journal-title":"Int Orthop"},{"key":"10.1016\/j.otsr.2020.102778_bib0435","article-title":"Revision of syndesmosis screw fixation","author":"Bafna","year":"2019","journal-title":"Foot Ankle Spec"},{"key":"10.1016\/j.otsr.2020.102778_bib0440","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1186\/s12891-017-1645-7","article-title":"A systematic review of suture-button versus syndesmotic screw in the treatment of distal tibiofibular syndesmosis injury","volume":"18","author":"Zhang","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.otsr.2020.102778_bib0445","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.injury.2011.10.002","article-title":"Tightrope fixation of ankle syndesmosis injuries: clinical outcome, complications and technique modification","volume":"43","author":"Naqvi","year":"2012","journal-title":"Injury"},{"key":"10.1016\/j.otsr.2020.102778_bib0450","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.ijsu.2018.11.007","article-title":"Comparison of suture button fixation and syndesmotic screw fixation in the treatment of distal tibiofibular syndesmosis injury: a systematic review and meta-analysis","volume":"60","author":"Xie","year":"2018","journal-title":"Int J Surg"},{"key":"10.1016\/j.otsr.2020.102778_bib0455","doi-asserted-by":"crossref","first-page":"3156","DOI":"10.1007\/s00167-017-4820-3","article-title":"Lower complication rate and faster return to sports in patients with acute syndesmotic rupture treated with a new knotless suture button device","volume":"26","author":"Colcuc","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.otsr.2020.102778_bib0460","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1177\/0363546516664713","article-title":"Suture button fixation versus syndesmotic screws in Supination-external rotation type 4 injuries: a cost-effectiveness analysis","volume":"45","author":"Neary","year":"2017","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.otsr.2020.102778_bib0465","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1016\/j.injury.2009.03.011","article-title":"Delayed operative treatment of syndesmotic instability. Current concepts review","volume":"40","author":"van den Bekerom","year":"2009","journal-title":"Injury"},{"key":"10.1016\/j.otsr.2020.102778_bib0470","doi-asserted-by":"crossref","first-page":"66","DOI":"10.2106\/JBJS.J.00030","article-title":"Salvage of chronic instability of the syndesmosis with distal tibiofibular arthrodesis: functional and radiographic results","volume":"93","author":"Olson","year":"2011","journal-title":"J Bone Joint Surg Am"}],"container-title":["Orthopaedics & Traumatology: Surgery & Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877056820303698?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877056820303698?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T03:44:34Z","timestamp":1761795874000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1877056820303698"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["S1877056820303698"],"URL":"https:\/\/doi.org\/10.1016\/j.otsr.2020.102778","relation":{},"ISSN":["1877-0568"],"issn-type":[{"value":"1877-0568","type":"print"}],"subject":[],"published":{"date-parts":[[2021,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Traumatic injuries of the distal tibiofibular syndesmosis","name":"articletitle","label":"Article Title"},{"value":"Orthopaedics & Traumatology: Surgery & Research","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.otsr.2020.102778","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Masson SAS.","name":"copyright","label":"Copyright"}],"article-number":"102778"}}