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Fixation of anterior syndesmotic injury

Avulsion from the anterior tibial tubercle (Tillaux-Chaput)

Reduce the fragment with a small dental hook and preliminarily fix it with a 1.0 mm K-wire.

Drill a hole with a 2.5 mm drill bit and protection sleeve, as perpendicularly as possible to the fracture line, without drilling the far cortex.

Measure the depth. Tap the fragment only with the 4.0 mm tap and protection sleeve. Insert the chosen 4.0 mm cancellous screw with a washer.


If the fragment is too small for 4.0 mm screw fixation, use a 2.0 mm cortex screw or suture the fragment to the periosteum of the anterior tibia.