Treatment of the rupture of the distal tibiofibular syndesmosis with “Engelbrechts syndesmosis hook”

After completing the osteosynthesis of the lateral malleolus, the hook is positioned 3–5 cm cranial of the syndesmosis and fixed to the tibia with a screw. It is expected to allow undisturbed ligament healing of the syndesmosis with early formation or fibres under limited motion. No immobilisation is necessary and no early removing of the implant. Results: Of 62 patients questioned, 53 were examined, after an average of 50 months (2–6 years p. o.). Using the Weber score, 51 had excellent or good results. Twelve patients reported discomfort while jumping, in five cases the ROM concerned dorsal extension, and in three cases plantar flection was reduced. Four patients showed distinct radiologic signs of osteoarthrosis, and two patients slight signs.