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Distal intertrochanteric ligament rupture: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
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ICD-10 code
S86.8 Injury of other muscles and tendons at leg level.
What causes a distal tibiofibular joint ligament tear?
Rupture of the ligaments connecting the tibia and fibula in the distal part usually accompanies ankle fractures, but can also be isolated. The mechanism of injury is indirect. The main component of violence is excessive deviation of the foot with its simultaneous rotation or rotation of the shin with the foot bent and supinated. The anterior and posterior ligaments of the tibia are torn, the "fork" of the ankle joint diverges, incongruence occurs between the diverged tibia bones. Support on the leg becomes impossible.
Symptoms of a Distal Tibiofibular Joint Tear
Anamnesis
The anamnesis indicates an injury with a corresponding mechanism.
Inspection and physical examination
The ankle joint is enlarged and deformed due to edema, traumatic synovitis and subluxation of the foot outward. Movement in the joint is limited, and axial loading is impossible due to pain. Palpation can reveal mobility of the tibia in the distal section by squeezing the shin in the ankle area. The convergence and divergence of the "fork" is felt at the moment of application and cessation of force.
Diagnosis of distal tibiofibular ligament rupture
X-rays of the ankle joint reveal a divergence of the tibia bones - the shadow of the fibula does not overlap the contours of the tibia, the joint space becomes wedge-shaped, and a subluxation of the foot outward is visible.
Treatment of distal tibiofibular ligament rupture
Indications for hospitalization
Treatment of rupture of the distal tibiofibular joint ligaments is carried out in a hospital setting.
Conservative treatment of distal tibiofibular ligament rupture
In conservative treatment of rupture of the distal tibiofibular joint ligaments, the relationship of the tibia bones is restored manually or with hardware. A splint-circular bandage is applied (a U-shaped splint, which after hardening is converted into a circular bandage) from the tips of the fingers to the upper third of the shin.
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Surgical treatment of rupture of the distal tibiofibular ligaments
If the reduction fails, they resort to surgical treatment - fixing the "fork" of the distal section of the tibia with a metal bolt or other acceptable method. Then they use a plaster "boot".