Flexible Triple Fixation for Chronic Syndesmotic Instability: A Technical Tip

The triple-fixation technique proved effective in stabilizing chronic syndesmotic injuries in all cases presented. This construct may be considered a viable option for addressing residual instability in patients with chronic distal tibiofibular joint lesions. However, these findings should be interpreted within the context of the study's limitations, including its technical-tip design, small cohort size, relatively short follow-up for a chronic pathology, and lack of randomization.<b>Level of Evidence:</b> V, technical tip and case report.