Operative aspects of the syndesmotic screw: review of current concepts.

The distal tibiofibular syndesmosis is important for stability of the ankle mortise and thus for weight transmission and walking. Syndesmotic injuries are most commonly associated with fibular fractures, but they can also occur in isolation or with damage to the lateral ankle ligament after traumatic supination. The need for trans-syndesmotic fixation of the distal tibiofibular joint has been controversial. The goal of this review was to collect evidence on the technical aspects of performing an osteosynthesis using a syndesmotic screw and to formulate some recommendations for clinical practice.