What is a high ankle sprain?
- A set of ligaments holds the tibia and fibula together above the ankle joint. This set of ligaments is referred to as the syndesmosis. These ligaments act as shock absorbers that keep the tibia and fibula together amidst forces that could spread the tibia and fibula apart.
- A high ankle sprain is a partial or complete tear of the ligaments of the syndesmosis.
- High ankle sprains most often occur when the foot is forcibly twisted, either from a contact or non-contact injury.
What are the symptoms of a high ankle sprain?
- Pain radiating up the leg from the ankle.
- Pain while walking.
- Inability to perform a calf raise.
- Swelling or bruising (typically to a lesser degree compared to routine ankle sprains).
How is a high ankle sprain diagnosed?
- High ankle sprains are suspected based on the circumstances of the injury, the symptoms, and the examination.
- Things that are helpful on physical examination may include a fibular compression test: the physician squeezes the tibia and fibula together in several different positions and sees if it causes pain.
- Sometimes an x-ray is taken to be sure the problem is a sprain of a ligament and not a fracture of the bone.
Is surgery necessary for high ankle sprains?
- Most sprains heal with time. Any treatment is for comfort and to limit stiffness.
- Sometimes completely torn ligaments are considered for surgery or reconstruction.
- Standard surgical procedure is to insert screws between the tibia and fibula to hold the two bones together.
What is the recovery like?
- Ligaments reach full strength between 6 and 12 months after injury.
- Symptoms improve for a year or more.
- Some patients with partial tears return to full activity in 6 weeks if they are comfortable enough to be effective at their sport.