Evaluation and Treatment Recommendations for Acute Injuries to the Ankle Syndesmosis Without Associated Fracture

Ankle ligamentous injuries are commonly seen in athletes in a variety of sports. Surveys of physicians and trainers of professional sports teams have identified syndesmotic injuries as among the most difficult to treat. In particular, injuries of the ankle syndesmosis have been strongly linked with...

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Bibliographic Details
Published in:Sports medicine (Auckland) 2014-02, Vol.44 (2), p.179-188
Main Authors: Miller, Timothy L., Skalak, Timothy
Format: Article
Language:English
Subjects:
Ankle
Ankle Injuries - classification
Ankle Injuries - diagnosis
Ankle Injuries - diagnostic imaging
Ankle Injuries - therapy
Classification
Diabetes
Football
Humans
Immobilization - methods
Ligaments
Medicine
Medicine & Public Health
NMR
Nuclear magnetic resonance
Orthopedic Procedures - methods
Physical Therapy Modalities
Radiography
Recovery of Function
Review Article
Sports injuries
Sports Medicine
Surgery
Time Factors
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Description
Summary:Ankle ligamentous injuries are commonly seen in athletes in a variety of sports. Surveys of physicians and trainers of professional sports teams have identified syndesmotic injuries as among the most difficult to treat. In particular, injuries of the ankle syndesmosis have been strongly linked with a prolonged recovery and increased time to return to play. Due to sudden external rotation with the tibiotalar joint in dorsiflexion, these structures are commonly injured in association with fractures of the distal fibula. Surgery is indicated in cases with associated fractures and ligamentous instability, but optimal treatment for syndesmosis injuries without an associated fracture is less clear. A thorough history and physical examination, as well as appropriate imaging, are necessary to effectively diagnose and classify the injury. For stable injuries, short-term immobilization and functional rehabilitation is recommended. Unstable Grade 2 and 3 injuries require surgical fixation. Debate currently exists over rigid screw fixation versus suture button techniques as the ideal fixation method.
ISSN:0112-1642
1179-2035
DOI:10.1007/s40279-013-0106-1