High Ankle Sprain & Syndesmosis Injury

A High Ankle Sprain or Syndesmosis Injury occurs with external rotation injuries. It may be mistaken for a low ankle sprain but improper diagnosis and treatment can lead to complications. Missed injuries or improper treatment may lead to end stage ankle arthritis.


High ankle sprains are found in 0.5% of all ankle sprains without a fracture and 15% of all ankle fractures. Anatomically the strong ligaments that hold the fibula (long bone on the outside ankle) and tibia (shin bone) becomes stretched or torn. This leads to instability and malalignment within the ankle joint. Instability and malalignment leads to abnormal stresses to the ankle joint and may cause end stage arthritis.


Symptoms include ankle pain, difficulty weight bearing, pain over the syndesmosis ligaments, and pain with squeeze of the tibia and fibula in the mid calf region. During your exam your foot and ankle specialist will perform a thorough physical exam. Xray images may be ordered of the injured ankle and possibly the uninjured ankle for comparison. If xray images are inconclusive, a CT or MRI may be ordered.


Treatment for high ankle sprains (syndesmosis injuries) typically require surgical treatment. Surgical treatment involves fixing the syndesmosis ligament with either screws or a high strength suture button as well as treating any other associated injuries. Post-operatively patient’s are kept non weight bearing for 6-12 weeks. Once the sprain or syndesmosis injury has healed, the screws may need to be removed.


Without proper treatment this injury typically has a prolonged and highly variable recovery process. The injury causes instability and malalignment which may lead to end stage arthritis of the ankle joint. Proper diagnosis and treatment is imperative for healing of the injury and good outcomes.


Your foot and ankle specialist at Advanced Foot and Ankle Center in Mckinney and Prosper TX will perform a thorough examination along with xrays and other imaging depending on your symptoms and timeline of injury. Call us today at 972-542-2155 to set up your appointment!


Look out for our next blog post about Osteochondral defects, Peroneal Tendon injuries, and other related conditions.