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When Is Surgery Necessary for a High Ankle Sprain?

Different types of ankle sprains range from mild to severe, affecting other ankle areas. For example, a high ankle sprain involves the ligaments that support the tibia and fibula.

Also known as a syndesmotic injury, a high ankle sprain is less joint than a low ankle sprain but is even more severe. You're at risk for a high ankle sprain if you're an athlete who plays football, soccer, or basketball.

Surgery isn't always required for a high ankle sprain unless it's a severe injury that affects daily living or doesn't get better with conservative treatments.

If you have a high ankle sprain, Dr. Marque A. Allen and the Sports Medicine Associates of San Antonio team offer various treatments, including surgery. Dr. Allen is an experienced foot and ankle specialist who carefully evaluates your injury to provide the best treatment option for your needs.

What is a high ankle sprain?

A high ankle sprain is a type of sprain that affects the syndesmosis, or ligaments that support the lower leg bones. These ligaments help keep the tibia and fibula in place at the high point of the ankle.

Low ankle sprains are more common than high ankle sprains unless you play certain sports that strain the upper portion of your ankle. You're at risk for a high ankle sprain when you play sports like:

However, you can still have a high ankle sprain without being an athlete; it's more common in these sports.

A high ankle sprain happens when you have an injury that flexes your foot and then rotates the ankle either outwards or inwards. You may have a high ankle sprain if you notice any of the following symptoms:

If you experience any of the above symptoms, it's helpful to seek treatment as early as possible to avoid significant complications from a high ankle sprain that doesn't heal correctly.

Conservative treatments that help

After confirming a high ankle sprain, Dr. Allen often recommends conservative treatments to manage pain and other symptoms. For instance, he may recommend the RICE protocol several days after the initial injury to control inflammation and discomfort.

RICE stands for rest, ice, compression, and elevation. You should stay off your ankle for a few days to allow the ligaments to heal. Applying ice several times daily for the first few days will enable you to control swelling.

Compression with a bandage keeps inflammation down, which helps control pain, while elevation helps with swelling and discomfort.

Dr. Allen may also recommend using over-the-counter anti-inflammatory medications for the first week or so to control pain and swelling. He may also provide you with a brace or splint to stabilize the ankle while you heal.

Physical therapy is another conservative treatment that helps you regain motion flexibility and reduces pain. At the same time, the ankle joint heals from a high ankle sprain.

You may get the best results from pairing RICE, medications, and physical therapy during the six to eight weeks it takes for a high ankle sprain to heal fully.

Do I need surgery for a high ankle sprain?

Most people with a high ankle sprain can heal appropriately with conservative treatments. Still, some people may require surgery to heal the joint fully.

Surgery is typically only necessary when your ligaments don't heal appropriately through conservative treatments or your ankle remains extremely unstable after a high ankle sprain.

Dr. Allen may recommend surgery for a high ankle sprain when the syndesmotic ligaments tear entirely, leading to severe instability of the high ankle joint. If you have a fracture of your tibia or fibula along with a high ankle sprain, he also recommends surgery for the best outcomes.

Surgery for a high ankle sprain involves Dr. Allen placing screws in the tibia and fibula to keep them together and provide support so the ligaments can heal. After they've recovered, he may go back in to remove the screws if necessary to prevent them from breaking under repeated pressure.

After surgery, you must be in a cast or boot to stabilize the ankle so the ligaments and surgery site can heal properly. It would help if you also began physical therapy to regain strength and motion around the affected joint.

Call Sports Medicine Associates of San Antonio today at one of our conveniently located offices in Texas, or request a consultation with Dr. Allen on our website.

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