Question 1

I sprained my ankle playing football 3 weeks ago and it's still really painful and swollen. Could this be a high ankle sprain instead of a regular ankle sprain?

Accepted Answer

High ankle sprains (syndesmotic injuries) are often initially misdiagnosed as lateral ankle sprains because both cause ankle pain and swelling. Key differences: high ankle sprains cause pain above the ankle (between the tibia and fibula bones), not on the sides of the ankle like lateral sprains. The squeeze test (squeezing your calf reproduces pain above the ankle) and external rotation test are positive. High ankle sprains take 3-4 months to heal versus 4-6 weeks for lateral ankle sprains. If your ankle sprain isn't improving after 3 weeks and you have pain above the ankle, see an orthopedic surgeon for examination and weight-bearing X-rays to check for syndesmotic injury.

Question 2

My surgeon says I need surgery for my high ankle sprain. Can't I just wear a boot and let it heal like a normal ankle sprain?

Accepted Answer

The decision for surgery versus conservative treatment depends on whether your syndesmotic injury is stable or unstable on weight-bearing X-rays. Stable injuries (no widening of the space between tibia and fibula when you put weight on it) can heal with CAM boot treatment. Unstable injuries (the bones separate when you put weight on it) require surgery to stabilize the tibiofibular joint - if left untreated, the bones heal in the wrong position causing chronic ankle instability, pain, and early arthritis. Surgery achieves 85-90% good outcomes versus 40-50% if unstable injuries treated conservatively. Your surgeon has identified instability on X-rays requiring fixation to restore normal ankle mechanics.

Medical Disclaimer

High Ankle Sprains (Syndesmotic Injuries)

📖What is High Ankle Sprains (Syndesmotic Injuries)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention