What Is an Ankle Fracture with a Syndesmotic Injury?

I recently competed in our state high school rodeo finals and injured my ankle during the calf roping event. I needed surgery with two pins inserted into my ankle, and the doctor said it’s an ankle fracture with a syndesmotic injury. What exactly does that mean?

The syndesmosis refers to the group of ligaments and connective tissue that hold the bottom of your two lower leg bones together—the tibia (shin bone) and the fibula (the smaller bone on the outside of your leg). These ligaments are crucial for stabilizing the ankle joint and allowing proper movement.

The syndesmosis is made up of four ligaments and a connective tissue band called the interosseous membrane, which runs between the two bones.

A syndesmotic injury happens when these ligaments are either sprained or completely ruptured. Sometimes, the injury involves a fracture of one or both bones. In more severe cases—like yours, where there is both a bone fracture and syndesmotic damage—surgery is necessary. The goal of the surgery is to realign the bones and stabilize the joint to restore normal movement and function. The pins help ensure that the bones heal properly and the joint regains stability.

Reference: Charalampos Zalavras, MD, PhD, and David Thordarson, MD. Ankle Syndesmotic Injury. Journal of the American Academy of Orthopaedic Surgeons. June 2007. Vol. 15, No. 6, pp. 330-339.