Syndesmosis sprain (“high ankle sprain”)

This is an injury involving the soft tissue stabilizing the joint between the two leg bones (tibiofibular joint) at the ankle.  This less common type of ankle sprain can occur from the “turning the ankle out”, and can be associated with fractures around the ankle.

Signs/symptoms include pain throughout the entire ankle and leg, swelling, limited ankle motion or function.

Treatment depends on the severity of the sprain and the stability of the ankle joint.  For mild sprains, treatment is similar to a lateral ankle sprain but can take nearly twice as long to recover. Rest, ice, compression, elevation (RICE), bracing or immobilization, anti-inflammatory medicines, protected weight bearing, followed by aggressive physical therapy to strengthen the muscles supporting the ankle.

Surgical treatment is necessary if there is any instability of the ankle joint or associated fracture of the ankle. Fixation of the tibiofibular joint or fractures with screws is required to maintain the normal alignment of this joint.