"High" Ankle Sprains

We have been discussing the ankle in class, and one of the topics has been the "high" ankle sprain. The most common type of ankle sprain is the "lateral" ankle sprain, which damages the ligaments on the outside of the ankle that connect the talus to the fibula. Most of the time when people "roll" their ankle, they sustain a "lateral" ankle sprain. While not as common, the "high", or "syndesmosis" ankle sprain, can be much more debilitating. With a "high" ankle sprain, there is damage to the ligaments of the distal tibiofibular joint, primarily the anterior inferior and posterior inferior tibiofibular ligaments, and sometimes the interosseous membrane. To sustain a high ankle sprain, the talus, through hyperdorsiflexion, is forced up between the tibia and fibula, thus separating the bones from each other. This often occurs during a pile up in football when a player lands on the back of the leg of a lineman. Recovery for a high ankle sprain is often lengthy. Every time we walk or run, the talus is forced up into the distal tibiofibular joint. In a healthy person, this is not a problem, but in a person that has damaged these ligaments, it makes recovery difficult.