High ankle sprain
Encyclopedia
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. 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 American
and Canadian football
, ice hockey
, basketball
and soccer.
and fibula.
When 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. When surgery is needed recovery will take 6 months or longer.
Sprain
A sprain is an injury in a joint, caused by the ligament being stretched beyond its capacity. A muscular tear caused in the same manner is referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary...
of the syndesmotic ligaments
Inferior tibiofibular articulation
The distal tibiofibular joint is formed by the rough, convex surface of the medial side of the distal end of the fibula, and a rough concave surface on the lateral side of the tibia.Below, to the extent of about 4 mm...
that connect the tibia
Tibia
The tibia , shinbone, or shankbone is the larger and stronger of the two bones in the leg below the knee in vertebrates , and connects the knee with the ankle bones....
and fibula on the lower leg. Syndesmotic ankle sprains are known as high because their location on the lower leg is above the ankle. 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 American
American football
American football is a sport played between two teams of eleven with the objective of scoring points by advancing the ball into the opposing team's end zone. Known in the United States simply as football, it may also be referred to informally as gridiron football. The ball can be advanced by...
and Canadian football
Canadian football
Canadian football is a form of gridiron football played exclusively in Canada in which two teams of 12 players each compete for territorial control of a field of play long and wide attempting to advance a pointed prolate spheroid ball into the opposing team's scoring area...
, ice hockey
Ice hockey
Ice hockey, often referred to as hockey, is a team sport played on ice, in which skaters use wooden or composite sticks to shoot a hard rubber puck into their opponent's net. The game is played between two teams of six players each. Five members of each team skate up and down the ice trying to take...
, basketball
Basketball
Basketball is a team sport in which two teams of five players try to score points by throwing or "shooting" a ball through the top of a basketball hoop while following a set of rules...
and soccer.
Diagnosis
Although painful, many of the more durable athletes are able to play through the pain, like matthew brewster during the 2004 football season. This often happens in football. Athletes with high ankle sprains usually come to a physician, physical therapist, athletic 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 physical therapists or physicians 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. High ankle sprains may be harder to diagnose than normal ankle sprains because swelling is usually minor or non existent compared to common ankle sprains, for this reason some may underestimate the severity of the injury. The physical therapist, athletic trainer, or physician 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, CT scan or radiographs are sometimes used to check or see severe high ankle sprains and check for displacement of the tibiaTibia
The tibia , shinbone, or shankbone is the larger and stronger of the two bones in the leg below the knee in vertebrates , and connects the knee with the ankle bones....
and fibula.
Treatment
Treatment of high ankle sprains depends on severity. An athlete may be out for as little as 2–3 days or as long as 6 months. 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)
- Elevation
When 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
Tibia
The tibia , shinbone, or shankbone is the larger and stronger of the two bones in the leg below the knee in vertebrates , and connects the knee with the ankle bones....
and fibula stays normal. Unstable high ankle sprains occur when two or all three syndesmotic ligaments are torn and the tibia
Tibia
The tibia , shinbone, or shankbone is the larger and stronger of the two bones in the leg below the knee in vertebrates , and connects the knee with the ankle bones....
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. When surgery is needed recovery will take 6 months or longer.
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