High Ankle Sprain & Syndesmotic Injury

Question 1

What is the incidence of syndesmotic injury?

Answer 1

0.5% of sprains without fracture

13% of all ankle fractures

Question 2

What is the best predictor of return to play in high ankle sprain?

Answer 2

Syndesmotic tenderness

Question 3

What are radiographic measurements in suspected syndesmotic injury?

Answer 3

AP view: >6mm tib-fib overlap, < 6mm tib-fib clear space

Mortise: >1mm tib-fib overlap, 4mm

Question 4

Surgical treatment for syndesmotic injuries?

Answer 4

Tightrope, 3.5mm or 4.5mm screws, two preferably; 3-4 cortices; NWB for 6-12 weeks

Question 5

Which test for acute syndesmotic injury of the ankle has the fewest false-positive results and smallest inter-observer variance when used intraoperatively?

Answer 5

Cotton test