High Ankle Sprain/Syndesmosis Injury
What is it: A syndesmotic injury or high ankle sprain is an injury to the ligaments above the ankle joint. These ligaments are important in keeping the two bones of the lower leg together – the tibia and fibula. If left untreated these injuries can lead to chronic pain and potentially ankle arthritis.
Management: Initial assessment will involve a clinical review combined with radiological assessment of the injury. Dr Unsworth-Smith will assess your injury and determine if surgical management is required. If the ankle joint is unstable after injury, then ankle arthroscopy and syndesmotic stabilisation surgery is indicated to reduce the separation between the tibia and fibula, so that the ligaments can heal.
The surgery involves two 1cm incisions for the arthroscopy (key hole surgery) where removing any loose cartilage and/or scar tissue from the ankle will be performed. A separate incision on the outside of the ankle to stabilise the tibia and fibula tightropes or screws.
Postoperatively: Patients are safe to go home on the day of the surgery. You will be placed in a plaster until wound review at 2 weeks. At 2 weeks you will be placed in a walking boot that must be worn at all times including when sleeping. The boot will allow commencement of range of motion exercises at 2 weeks.
Return to most activities occurs between 6-18 weeks with full recovery expected at 6 months.