n International SportMed Journal - Syndesmotic ankle sprains in athletes : review article




With the ever-increasing forces involved in high-level sports participation, there has been an associated increase in the frequency of syndesmotic ankle injury. Due to the spectrum of injury and frequent failure of proper diagnosis, the exact incidence is unknown, but ranges from 1-18% of patients who present with ankle sprain symptoms. Not only can these injuries be difficult to differentiate from a typical lateral ankle sprain, they can also be quite difficult to treat. Careful examination and appropriate diagnostic studies are keys to proper diagnosis and to distinguishing between a stable and unstable injury. The stable syndesmotic sprain can be treated non-operatively, but the time to return to sport can be lengthy in comparison to the more common lateral sprain. Unstable syndesmosis injuries should be treated operatively to avoid late sequelae that can include pain, instability, and arthritis. Late treatment of missed injuries can include arthroscopic debridement, reconstruction with tendon graft, or arthrodesis. Proper postoperative rehabilitation should allow a period of progressively increased weight bearing and strengthening exercises, while concentrating on range-of-motion and proprioception. Return to sports for those athletes who are injured more severely requires both successful surgery and the successful completion of a functional rehabilitation programme.


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