High ankle sprain • tibiofibular stability • sport
Syndesmosis injuries
The syndesmosis links the tibia and fibula above the ankle. It can be injured by rotational trauma and requires careful assessment of stability.
What symptoms may suggest this condition?
- Pain above the ankle, worse with rotation or walking.
- Difficulty returning to running, cutting or pivoting sports.
- In unstable injuries, a sense of instability or persistent pain.
How is the diagnosis confirmed?
Clinical examination is complemented by X-rays. Depending on the situation, stress imaging, CT or MRI may help distinguish stable from unstable injury and identify associated lesions.
Is surgery always necessary?
Stable injuries can often be treated non-operatively with protection, progressive weight-bearing and rehabilitation. Return to sport varies and is often slower than after a simple lateral sprain.
When should surgery be discussed?
Syndesmosis fixation may be indicated when the joint is unstable, including some fractures or severe ligament injuries. Technique and postoperative protocol depend on the injury pattern and associated lesions.
Source patient : AOFAS / AAOS. General information, to be adapted to each clinical situation.
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