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What is a Syndesmotic Injury?
A syndesmotic injury, commonly known as a high ankle sprain, occurs when the ligaments connecting the tibia and fibula above the ankle joint are damaged. These ligaments, collectively called the syndesmosis, stabilize the ankle and allow slight movement between the bones. Injury to this area can compromise ankle stability and lead to pain, swelling, and difficulty walking.
What are the Causes of a Syndesmotic Injury?
Syndesmotic injuries are often caused by rotational or twisting forces on the ankle. Common causes include:
- Sports-related trauma, especially in football, soccer, basketball, and skiing
- Forceful external rotation of the foot while the leg is planted
- Direct trauma to the ankle
- High-impact falls or accidents
- Associated ankle fractures that stress the syndesmotic ligaments
What are the Symptoms of a Syndesmotic Injury?
Symptoms may vary depending on severity, but often include:
- Pain above the ankle, especially with movement or rotation of the foot
- Swelling and tenderness along the front or sides of the ankle
- Difficulty walking or bearing weight
- Feeling of instability or looseness in the ankle
- Bruising in some cases, especially with associated fractures
How is a Syndesmotic Injury Diagnosed?
Diagnosis begins with a physical examination, including tests such as the squeeze test or external rotation test. Imaging may be required to confirm the extent of injury or detect associated fractures:
- X-rays to check for widening of the ankle mortise
- MRI to assess ligament damage
- CT scan for complex fractures or surgical planning
What are the Treatment Options for a Syndesmotic Injury?
Treatment depends on the severity of the injury:
- Non-surgical: Rest, ice, compression, elevation (RICE), immobilization with a boot or cast, and physical therapy
- Surgical: Required for severe or unstable injuries; may involve syndesmotic screws or suture-button fixation to stabilize the joint
- Gradual return to activity is guided by healing progress and rehabilitation
Syndesmotic injuries require careful management to restore ankle stability, relieve pain, and prevent long-term complications.
If you wish to be advised on the most appropriate treatment, please call to schedule an appointment or click to request an appointment online.
