Tibiofibular Synostosis ICD-9
- 718.57 (ankylosis of joint; ankle and foot)
Tibiofibular Synostosis Etiology / Epidemiology / Natural History
- Generally develops after an eversion (high) ankle sprain with disruption of the interosseous membrane.
- Occurs 6-12 months after ankle sprain.
Tibiofibular Synostosis Anatomy
- Distal tibiofibular syndesmosis consists of: AITFL, IOL, interosseous membrane, PITFL, and ITL.
- AITFL = anterior-inferior tibiofibular ligament: Originate = anterolateral (Chaput’s) tubercle of the tibia. Insertion: anterior (Wagstaffe’s) tubercle of the fibula.
- IOL = interosseous ligament: thickened distal part of the interosseous membrane.
- Interosseous membrane,
- PITFL = posterior-inferior tibiofibular ligament. Origin: the posterior (Volkmann’s) tubercle of the tibia. Insertion: the posterior part of the lateral malleolus.
- ITL = inferior transverse ligament: fibrocartilaginous distal portion of the PITFL.
Tibiofibular Synostosis Clinical Evaluation
- Limited ankle dorsiflexion. +/- ankle pain.
Tibiofibular Synostosis Xray / Diagnositc Tests
- A/P, Lateral and Mortise views of the ankle and AP, lateral views of the entire length of the tibia and fibula. Demonstrate bone growth in the area of the Distal tibiofibular syndesmosis.
- Bone scan: indicated if considering surgical excision. Bone scan should demonstrate ossification is complete (no uptake) before surgical excision.
Tibiofibular Synostosis Classification / Treatment
- May return to sport with no limitations if pain free.
- Surgical excision: indicated only in patients with persistent pain.
Tibiofibular Synostosis Associated Injuries / Differential Diagnosis
Tibiofibular Synostosis Complications
Tibiofibular Synostosis Follow-up Care
Tibiofibular Synostosis Review References