Syndesmotic injuries at the ankle joint are injuries to the ligaments that connect the tibia and fibula. They are the most severe ligament injuries to the ankle, and occur either in isolation or at the same time as an ankle fracture. External rotation and/or hyperdorsiflexion are the most common mechanisms causing syndesmotic injuries. These injuries can occur during activities like sports or dancing, and any other fall. Patients with syndesmotic injuries like acute ankle sprains experience acute ankle instability, pain & functional problems.