This article describes the reconstruction of the tibiofibular and talocrural joint in a boy with a chronic syndesmotic injury with lateral talar shift. The anterior-posterior radiograph showed a widened medial clear space. MR imaging with an additional double oblique plane depicted an old Wagstaffe's fracture with an intact anterior tibiofibular ligament and a fresh fibular physical fracture, as well as a thickened deltoid ligament and synovitis in the medial joint space. Reconstruction was performed by anthroscopic removal of the synovitis from the medial recessus, followed by fixation of the fibular avulsion of the ATiFL with a staple after a syndesmotic set screw had been placed during compression of the mortise. One year after reconstruction (and removal of the set screw) the talocrural joint is congruent. The boy has fully recovered and has resumed all sporting activities without complaints.

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Foot and Ankle Surgery
Department of Orthopaedics

Beumer, A., Hermans, J., Niesten, D.-D., & Heijboer, R. (2005). Late reconstruction of the anterior tibiofibular syndesmosis for ankle diastasis with talar shift in a 12-year-old boy. A case report. Foot and Ankle Surgery, 11(1), 49–53. doi:10.1016/j.fas.2004.10.002