Arthroscopic Reconstruction of the Posteroinferior Tibiofibular Ligament: An Operative Technique

The distal tibiofibular syndesmosis is crucial for ankle stability resisting diastasis and stabilizing against internal rotation and posterior fibular dislocation. Treatments for syndesmotic injuries include trans-syndesmotic screw or dynamic suture button fixation. In this technique, the torn posteroinferior tibiofibular ligament is reconstructed with anchor sutures running diagonally, mimicking the anatomic direction of the posteroinferior tibiofibular ligament fibers, ensuring syndesmotic anatomy and stability.