Orthopedic Center with Orthopedist and Arthroplasty Services

Ankle Surgery


Anterior tibiofibular ligament injury

Your ankle is a hinged joint that connects the foot with the leg, allowing for upward and downward movement. The bones of the tibia and fibula of the leg form a compartment between which the talus bone fits. The talus connects to the tibia and fibula through the ligaments.

The anterior tibiofibular ligament tilts downwards between the margins of the fibula and the tibia. It’s a point just above the ankle, at which these two bones meet, and the ligament holds the fibula and tibia bones together (syndesmosis).

Stability is important at the point between the tibia and the fibula because walking and running put a lot of pressure on this junction.

Injuries to the anterior tibiofibular ligament are less common than the traditional ankle sprain. However, individualized assessments are necessary to determine whether ankle surgery is needed.


Past tibiofibular ligament injuries

An injury to syndesmosis in the ankle (a severe form of ankle sprain) involves damage to the supporting ligaments in the ankle.

This injury is also known as high ankle sprain because it occurs in the ligaments above the ankle joint. With an injury to syndesmosis of the ankle, the anterior tibiofibular ligament, which connects the bones of the tibia and fibula, is stretched or may even rupture.

Recovery, even from medium-sized injuries of this type, can take six to eight weeks.

What are the causes?

When your foot “turns inward,” several types of ankle ligament injuries may occur. Placing your body’s entire weight on the ligaments of the lateral ankle causes the anterior tibiofibular ligament to stretch or break. This results in high torsion of the ankle. Sometimes pieces of bone can also break with the ligament.

In some cases, the strength of this sprain in the ankle can cause further damage.

The bones around the ankle can fracture, a piece of cartilage can be pulled out, other ligaments that connect to the bones in the foot can break or twist, or the tendons around the ankle can be damaged. Depending on your case and the type of damage sustained, ankle surgery may be required.

What are the symptoms?

Twists are among the most serious injuries of the foot and ankle. These syndesmosis injuries can become a problem for people who are trying to return to their normal activities.

When you sprain your ankle, you experience sharp, localized pain on the side of your injured ankle. Medium and moderate twists of syndesmosis can initially cause a sensation similar to a common twist.

Symptoms include swelling and pain in the back of the ankle and may be accompanied by discoloration and bruising on the skin. The pain radiates upward and along the side of the lower leg, and the ankle may appear somewhat unstable and weak.


A physical examination of the ankle is often the initial and most effective way to diagnose an anterior tibiofibular ligament injury. Our thorough diagnostic test involves moving the ankle in different positions to check the functionality of the ligament around the ankle. The ligament is tensioned by holding the lower leg so that it is still. Meanwhile, the ankle is turned outward.

Another test involves holding the calf just above the heel and tightening it. Any pain associated with this tightness test is an indication of a ligament injury. If syndesmosis injury is suspected, x-rays are then used to determine its severity. If the results show increased space between the tibia and fibula, this will confirm the diagnosis.


When it is found by the doctor that ankle surgery is the best option to treat the injury, some of the procedures adopted are those listed below.

Fixation with screws: Ankle surgery for the syndesmosis lesion is done to repair the separation between the tibia and the fibula. There are no barriers separating the tibia and fibula, the surgeon may simply need to put screws through the two bones, holding them together, while the ligaments recover.

Usually, surgeons use a screw with a large head. This allows for easy removal of the screw after two, or three months.

Open incision of ankle surgery: If the tibia and fibula are separated by debris, the surgeon may have to make an incision in the front end of the ankle. This will allow the surgeon to find and remove any scar tissue or other debris that is separating the bones.


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Unidade Higienópolis
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Unidade Higienópolis

Sala para um exame ortopédico completo, cujo objetivo é o diagnóstico preciso. A indicação de uma artroplastia de quadril se baseia no estudo clínico e radiográfico cuidadoso do paciente.

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