Syndesmotic Winkle Stability
Biomechanically, a certain amount of motion is allowed in all planes with respect to the distal ends of the tibia and fibula. When the ankle goes from full plantarflexion to full dorsiflexion, the distance between the lateral and medial malleoli increases by approximately 1.5 mm. Rotation of the tibia on the talus can also occur while a person is walking. This rotation can be as much as 6°.
The AITF ligament provides approximately 35% of ankle stability; the deep PITF, 33%; the interosseous PITF, 22%; and the superficial PITF, 9%.[2] Ogilvie-Harris et al experimentally demonstrated the importance of the syndesmotic ligaments to ankle stability by sectioning the ligaments.[2] Rasmussen demonstrated that the ligaments of the syndesmosis play
little role in the stability of the ankle as long as the other ligamentous structures are intact.[3] No study exists in which a purely ligamentous injury to the syndesmosis has been produced through externally applied stress (ie, external rotation and abduction).
The AITF ligament provides approximately 35% of ankle stability; the deep PITF, 33%; the interosseous PITF, 22%; and the superficial PITF, 9%.[2] Ogilvie-Harris et al experimentally demonstrated the importance of the syndesmotic ligaments to ankle stability by sectioning the ligaments.[2] Rasmussen demonstrated that the ligaments of the syndesmosis play
little role in the stability of the ankle as long as the other ligamentous structures are intact.[3] No study exists in which a purely ligamentous injury to the syndesmosis has been produced through externally applied stress (ie, external rotation and abduction).