A high ankle sprain occurs when the ligament, called the syndesmosis, is torn. This is a thick ligament that has several different parts holding the tibia and fibula together. The tibia and fibula are the 2 bones in the leg below the knee that sit on the top and the side of the ankle joint.
A more common inversion ankle sprain, will most likely tear of the anterior talofibular ligament and possibly the calcaneal fibular ligament. These ligaments are on the lateral side of the ankle around the fibula. Those ligaments sometimes do need to be surgically fixed and tightened if patients develop chronic lateral ankle instability.
When patients have a syndesmotic injury, the entire ankle joint can become more unstable. Because the tibia and fibula hold the talus in place, if the tibia and fibula are not closely approximated it can cause too much mobility of the talus within the ankle joint. If this is not addressed, it will cause osteoarthritis to develop within the ankle joint more long-term.
These injuries can be treated conservatively sometimes if the tear is mild and if patients do not have to return to activities as soon as possible. They are treated conservatively by either cast immobilization or immobilizing the foot and ankle in a Cam walker boot to try to let it heal.
If patients either have a severe injury where there is a lot of gapping between the tibia and fibula, or if they are trying to return to sport as soon as possible, we typically recommend addressing this surgically. The surgical procedure to address a syndesmotic injury can be performed minimally invasive. We typically use several suture anchors to close down the gap between the tibia and fibula and sometimes place a small 2 hole plate over the fibula as well. We can also use ankle arthroscopy to ensure the ankle joint is appropriately reapproximated.
If you suffer any foot and ankle injury or pain, the expert foot and ankle surgeons at Foot and Ankle Institute of Colorado are here to help you. We specialize in treating all sports medicine injuries of the foot and ankle to try to allow you to be able to return to your sport as soon as possible! Call us at 719-488-4664, so we can help you today.