High ankle sprain

A high ankle sprain, also known as a syndesmotic ankle sprain, is a sprain of the syndesmotic ligaments that connect the tibia and fibula on the lower leg. Syndesmotic ankle sprains are known as high because their location on the lower leg is above the ankle [ [http://www.orthogate.org/patient-education/ankle/ankle-syndesmosis-injuries.html Ankle Syndesmosis Injuries - Orthogate - Improving orthopedic care, education and research with Internet technologies ] ] . Unlike common ankle sprains when ligaments around the ankle are torn or receive injury through an inward twisting, high ankle sprains are caused when the lower leg and foot twist out. Anyone can get a high ankle sprain if the outward twisting is present although it is most common with athletes in the sports of football, ice hockey and soccer.

Diagnosis

Athletes with high ankle sprains usually come to a doctor or trainer or another person complaining of a dull or sharp pain in the outside-front of lower leg above the ankle. The pain is usually sharper when twisting is applied. Other times athletes may come to trainers or doctors and ask to be treated for common ankle sprain, only after treatment for the common ankle sprain isn't working is a high ankle sprain diagnosed [ [http://www.orthogate.org/patient-education/ankle/ankle-syndesmosis-injuries.html Ankle Syndesmosis Injuries - Orthogate - Improving orthopedic care, education and research with Internet technologies ] ] . High ankle sprains may be harder to diagnose than normal ankle sprains due to the fact that swelling is usually minor or non existent compared to common ankle sprains, for this reason some may underestimate the severity of the injury [ [http://www.wheelessonline.com/ortho/syndesmotic_sprain Syndesmotic Sprain - Wheeless' Textbook of Orthopaedics ] ] . The trainer or doctor will test for high ankle sprain in a number of ways, the squeeze test is most common by squeezing the calf or lower leg and usually slight turning [ [http://www.emedx.com/emedx/diagnosis_information/foot-ankle_disorders/high_ankle_sprain_outline.htm "High" Syndesmotic Ankle Sprain ] ] , CT scan, or radiographs are sometimes used to check or see severe high ankle sprains and check for displacement of the tibia and fibula.

Treatment

Treatment of high ankle sprains depends on severity. An athlete may be out for as little as 2-3 weeks or as long as 6 months [ [http://orthopedics.about.com/od/sprainsstrains/a/syndesmosis.htm High Ankle Sprain - Syndesmotic Injury ] ] . Minor high ankle sprains can be healed by reducing movement of the lower leg and foot with a brace or cast. Like common ankle sprains using the PRICE technique works well
*Protection (from further injury)
*Rest
*Ice
*Compression (wrapping, splint, or cast)
*ElevationWhen a high ankle sprain is diagnosed the doctor will determine if the injury is stable or unstable. Stable injuries are the less severe high ankle sprains when the placement of the tibia and fibula stays normal. Unstable high ankle sprains occur when two or all three syndesmotic ligaments are torn and the tibia and fibula are free to move around. Unstable injuries require more treatment usually surgery. During the surgery one or two screws are inserted in the lower leg for a few months (usually three) or until the ligaments have reformed and are able to hold the bones in the proper position [ [http://orthopedics.about.com/od/sprainsstrains/a/syndesmosis.htm High Ankle Sprain - Syndesmotic Injury ] ] . When surgery is needed recovery will take 6 months or longer.

Recent pro athletes with high ankle sprains

*Bob Sanders [ [http://www.usatoday.com/sports/football/nfl/colts/2008-09-17-sanders-out_N.htm?csp=34] ] NFL (2008)
*Sidney Crosby [ [http://sports.espn.go.com/nhl/news/story?id=3203602 ESPN - Crosby out indefinitely with high ankle sprain - NHL ] ] NHL (2008)
*Joffrey Lupul [ [http://sports.yahoo.com/nhl/news?slug=rotowire-offreyupulealingithi&prov=rotowire&type=fantasy Joffrey Lupul: Dealing With High Ankle Sprain - NHL - Yahoo! Sports ] ] NHL (2008)
*Marc-Andre Fleury [ [http://sports.espn.go.com/nhl/news/story?id=3203602 ESPN - Crosby out indefinitely with high ankle sprain - NHL ] ] NHL (2007)
*Terrell Owens [ [http://www.nfl.com/news/story?id=09000d5d80558ec8&template=with-video&confirm=true Cowboys' Owens has high ankle sprain; status in question ] ] NFL (2007)
*Tom Brady [ [http://www.bostonherald.com/sports/football/patriots/view.bg?articleid=1068430 Brady: High ankle sprain - BostonHerald.com ] ] NFL (2008)
*Dirk Nowitzki [ [http://sports.espn.go.com/nba/news/story?id=3309429 ESPN - Timetable for Nowitzki's return uncertain after diagnosis of ankle, knee injuries - NBA ] ] NBA (2008)
*Marcos Baghdatis

ee also

*Sprained ankle

References