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High Ankle Sprain

What is a High Ankle Sprain?

High Ankle Sprain

A high ankle sprain involves an injury to the ligaments directly above the ankle joint, called syndesmotic ligaments. These ligaments form a strong complex that holds the tibia and fibula together and can be torn during a rotational injury or along with an ankle fracture or an ankle sprain. This complex is called the syndesmosis.

Symptoms of a High Ankle Sprain?

  • Pain and swelling just above the ankle joint.
  • Bruising
  • You may or may not be able to bear weight after a high ankle sprain.


X-rays are taken initially. A stress exam may be performed under live X-ray. A CT scan and MRI can both be helpful for assessing the syndesmosis.

Nonsurgical Treatment

If there is a mild sprain of the syndesmotic ligaments but no instability this can be treated similar to a regular ankle sprain. Rest, ice, compression and elevation (R.I.C.E.) along with a period of immobilization is the mainstay of treatment. Rehabilitation with physical therapy is typically recommended.

Surgical Treatment

If there is instability or widening for the tibia and fibula at the syndesmosis this should be treated surgically. Typically screws are placed across the syndesmosis to realign and stabilize the tibial and fibula. The recovery is prolonged and usually includes 6 weeks non-weightbearing followed by 6 weeks very protected weightbearing. If this injury has gone undiagnosed there may be scar tissue impinging the area. Cleaning out the syndesmosis at the same time with arthroscopy can be performed.  The screws are then removed at 3 months after injury and physical therapy is initiated. If the alignment at the syndesmosis is not restored this can have serious consequences to the ankle joint and severe ankle arthritis can soon occur.

If you are having persistent pain in your ankle after an injury we encourage you to make an appointment for an evaluation today.

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