A high ankle sprain, also known as a syndesmotic ankle sprain, is a sprain of the syndesmotic ligaments that connect the tibia and fibula in the lower leg, thereby creating a mortise and tenon joint for the ankle. Unlike the common lateral ankle sprains, high ankle sprains are caused when the lower leg and foot externally rotates (twists out) . High ankle sprains are described as high because they are located above the ankle and comprise approximately 15% of all ankle sprains. They are less common than other ankle sprains but are typically more severe. High ankle sprains are classified into three grades: Grade I – the ligament is stretched but not torn; Grade II - the ligament is partially torn; and Grade III – the ligament is completely torn.
Symptoms of a high ankle sprain include pain, tenderness, and swelling in the front of the ankle and lower leg that may spread to the whole ankle and foot, popping or tearing feeling at the time of injury, and bruising that spreads to the heel or toes. Those who sustain high ankle sprains usually present with pain in the outside-front of the leg above the ankle, with increased discomfort when twisting (external rotation) is applied. In some cases, the diagnosis is only made after treatment for the more common, lateral, ankle sprain fails. Diagnosis may also be delayed because swelling is usually minor or nonexistent and the true nature of the injury unappreciated.
Rehabilitation is important for high ankle sprains. A significant percentage of these sprains also involve medial and/or lateral ankle ligament injury and slow recovery and continuing symptoms are common. However, limiting external rotation to protect healing ligaments is a primary concern and can usually be achieved by short leg casts, walking boots, and custom orthoses. High ankle sprains may take several weeks to several months to heal. Usually, the more pain and swelling, the more severe the ankle sprain and the longer it will take to heal. Surgery may be needed for a more severe injury.
To prevent high ankle sprains, it is recommended to do correct warm-up and stretching before practice or competition, balance training activities, wear ankle support during activities following injury, maintain good conditioning, ankle and leg flexibility, muscle strength, endurance, and cardiovascular fitness.
In summary, a high ankle sprain is a sprain of the syndesmotic ligaments that connect the tibia and fibula in the lower leg, located above the ankle and caused by external rotation of the lower leg and foot. It...
