High Ankle Sprain Treatment (Ankle Syndesmosis Treatment)

High ankle sprain treatment is a technique used to treat ankle syndesmosis or high ankle sprains. Read on to learn more about tightrope fixation treatment and how it can help you get moving again.

What You Need To Know About Treatment for High Ankle Sprains

What Is The Treatment For High Ankle Sprain?

The ankle joint is composed of a complex hinge with bone and ligaments supporting the ankle. This anatomy allows a wide range of motion in the ankle while providing stability throughout the range of motion. There are two groups of ligaments - the lateral ligaments located on the outside of the ankle and the medial ligaments located on the inside of the ankle.

High ankle sprains, also known as ankle syndesmosis, occur when the two ligaments holding two of the bones that make up the ankle joint (the fibula and tibia) are either strained or completely torn. Ankle syndesmosis surgery repairs and stabilizes the fibula and tibia, making it an effective way to treat high ankle sprains.

Why Is Treatment For High Ankle Sprain Performed?

High ankle sprains usually occur when the ankle is flexed and then twists suddenly. This can happen when running, jumping, or falling. It's common among athletes who participate in sports like football, basketball, soccer, lacrosse, or dance.

If a high ankle sprain is not responding to non-surgical treatment methods, syndesmosis surgery can help restore function and motion in the ankle.

What Happens During High Ankle Sprain Surgery?

In preparation for the procedure, the patient is positioned and anesthetized, and the surgeon makes an incision on the outer side of the ankle to access the joint. If bony fragments have broken loose from the fibula, they are either removed or stabilized. If the fibula has separated, the pieces are realigned.

The surgeon typically repairs the fibula by attaching a fixation plate. This plate is held in place by surgical screws. After the fibula has been stabilized, its relationship to the tibia can be restored and reinforced with the ZipTight™ system.

With the aid of a guidewire, the surgeon drills a tunnel through one of the lower holes of the fixation plate, through the fibula, and all the way through the tibia. The surgeon passes the ToggleLoc™ device, threaded with the ZipLoop™ cord, through this tunnel. Once it has cleared the tibia, the ToggleLoc™ is pulled back toward the tunnel. This causes it to swivel and lay flat against the tibial bone.

The surgeon pulls the ends of the ZipLoop™ cord to tighten the system, drawing a metal button against the fixation plate on the fibula. No knot is needed - once it is pulled tight, the ZipLoop™ cord remains tight, stabilizing the joint. If additional stability is needed, the surgeon may choose to drill a second hole and place a second ZipTight™.

When the procedure is complete, the incisions are closed, and the ankle is placed in a splint.

Are There Risks Associated With High Ankle Sprain Treatment?

Ankle syndesmosis surgery is usually successful in fixing high ankle sprains. However, like any surgical procedure, it has some associated risks:

  • Permanent stiffness in the ankle

  • Infection

  • Damaged nerves

  • Arthritis

Consult your physician about the risks and benefits of getting syndesmosis treatment.

Syndesmosis Surgery Recovery

Every patient is different, so the syndesmosis tightrope surgery recovery time varies. Typically, the patient will not be able to bear weight on the ankle for six to twelve weeks.

Once the doctor has determined that the ankle has healed properly, the patient can begin rehabilitation. This usually includes physical therapy, rest, ice, and other recommended treatments. Unlike the traditional screw syndesmosis reduction, the patient will typically not need to have the hardware removed before returning to unrestricted athletic activity.

Learn more about our treatment options by visiting the Foot and Ankle Center at Resurgens Orthopaedics.