Image Credit: Hospital For Special Surgery

Article Authors: Gordon Slater|Tandose Sambo

High ankle sprains account for approximately 15% of  all ankle related injuries. As a pretty popular orthopaedic condition, let us delve into the factors that influence the occurrence of this injury. 

What is a high ankle sprain? 

A high ankle sprain occurs when there is a tear in the ligaments that connect the tibia to the fibula. The image above, indicates how these two bones are connected to each other. The ligaments are collectively known as syndesmosis. As a hinge joint, our ankles are the connecting joint to our leg and foot bones. The vertical bones (tibia and fibula) intersect the ankle joint at the upper ankle, and the lower bones (talus) intersect the ankle at the point known as the lower ankle. As soft connecting tissue, the ligaments hold the joint together, provide flexibility and enable movement. 

A high ankle sprain is induced by a particular motion, causing it to be differentiated from a lower ankle sprain. Because the fibia and the tibula are vertical bones, a counter twist ninety degrees to the plane of the leg is extremely detrimental to the stability of the joint. With such an external twist, as the ligaments become displaced or torn, the patient will experience pain in the upper ankle region. The ligaments that are involved in a high ankle sprain are: 

*Anterior Inferior Tibiofibular Ligament 

*Posterior Inferior Tibiofibular Ligament 

*Interosseous Membrane 

If any of these ligaments are stretched or torn, a high ankle sprain can develop. 

What are the symptoms of a high ankle sprain? 

There are noticeable symptoms of a high ankle sprain. These include: 

  1. Pain : pain is the primary indicator that there is an issue in the body. It acts as an inhibitor to movement, and enables the appropriate care to be sought for healing. 
  2. Inability to bear weight, in order to limit mobility 
  3. Bruising that occurs after the injury 
  4. Swelling 

After an injury, an orthopaedic physical examination will determine if you have a high ankle sprain. Your orthopaedic specialist will have you attempt varying movements of the leg, and determine your level of mobility. One of the tests that will be conducted is a syndesmosis squeeze test to identify where the pain point is on the leg. High ankle sprains are often experienced on the upper parts of the ankle joint. Medical imaging inclusive of X-rays, MRI’s or CT scans are often included in the determination of the final diagnosis. 

How are High Ankle Sprains managed? 

High ankle sprains can be managed by the standard RICE practice.  The acronym RICE stands for: Rest, Ice, Compression and Elevation. Only severe cases require surgical intervention. Recovery can be expected within six to eight weeks. 

Reference:

Cleveland Clinic: High Ankle Sprain