Syndesmotic Injuries in Athletes

Ligamentous injuries around the ankle are one of the most common injuries in athletes, and syndesmotic (high ankle) sprains are being diagnosed at an increasing rate in recent years. Syndesmotic injuries can lead to significant pain, disability, and time away from sport with prolonged rehabilitation. Advanced imaging with ultrasound, computed tomography, and magnetic resonance imaging has improved the detection of syndesmotic injuries, and arthroscopy can confirm the diagnosis and help identify any additional intra-articular pathology. Recently, there has been increased interest and research surrounding the treatment of high-grade syndesmotic injuries in athletes with a focus on early rehabilitation and surgical intervention in select patients. Athletes can potentially return to training and play earlier if the syndesmosis is surgically stabilized, but the literature is controversial regarding the overall management of these injuries.