Understanding Syndesmotic Injuries
Syndesmosis injuries—commonly referred to as high ankle sprains—involve damage to the ligaments connecting the distal tibia and fibula. These ligaments, including the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), and the interosseous membrane, are critical for ankle stability. Injury usually occurs through external rotation or hyper-dorsiflexion mechanisms, particularly in pivoting sports. Such injuries are clinically significant because they often lead to prolonged disability and delayed return to play compared to lateral ankle sprains (Hunt & Wallace, 2022). Early diagnosis is crucial, as untreated injuries may progress to chronic instability, altered biomechanics, and even degenerative joint disease.
Indications for Surgical Intervention
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