High Ankle Sprains (Syndesmotic Sprains)

High ankle sprains involve injury to the syndesmotic ligaments connecting the tibia and fibula above the ankle joint. These injuries are less common than traditional ankle sprains but typically take longer to heal. They often occur in athletes during twisting or pivoting movements.

Anterior Ankle Impingement

    • Pain above the ankle, often worse with lateral movement

    • Swelling and tenderness over the syndesmosis

    • Difficulty bearing weight or running

  • Physical examination tests, including the squeeze and external rotation tests, help identify syndesmotic injury. X-rays and MRI confirm ligament damage and rule out associated fractures.

    • Non-surgical:  Rest, immobilization, and physical therapy focusing on strength and stability.

    • Surgical/minimally invasive:  Severe or unstable injuries may require fixation using screws or suture-button devices, sometimes performed arthroscopically.

  • Mild sprains often heal in 6–8 weeks; surgically treated cases may take 3–4 months for full return to sport.