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  • Writer's pictureRandon Hall, MD

Saquon Barkley - High Ankle Sprain

By video, Saquon looked to sustain an eversion injury of his right ankle with rotational component. With this type of injury mechanism, definitely confirms the reports of a high ankle sprain. This mechanism causes the talus bone to act as a lever to pry open the connection between the tibia and fibula and disrupt the associated ligaments. Many times the term "High Ankle Sprain" is used in sports without adequate explanation of the specific injury, as well as without differentiation from a common ankle sprain. Here is a quick break down...

Common vs High Ankle Sprain?

When an ankle injury occurs to the lateral and medial stabilizing ligaments this is referred to as a common ankle sprain.

However, there are another set of ligaments that hold the two lower leg bones together (tibia and fibula) that when injured constitute a high ankle sprain. Those ligaments include the anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament, transverse tibiofibular ligament and the interosseous membrane (ligament).

Ligaments Associated with High Ankle Sprain (Lateral View)

Ligaments Associated with High Ankle Sprain (Posterior View)

Return to Play Highly Variable

High ankle sprains without instability are generally managed with a conservative course of treatment. The process usually involves some form of immobilization, most commonly in a boot. Additionally, some degree of restricted weight-bearing is instituted based on pain and severity of the injury. Although return to play is highly variable, high ankle sprain treated non-operatively generally have an estimated return of about 6 weeks. On the other hand, surgical intervention for high ankle injuries is quite controversial. Options for surgical stabilization include a screw fixation or a suture fixation device called a tightrope. In regards to surgical stabilization, the treatment protocols are highly variable so it would be difficult to speculate on a return to play. Return to play after a high ankle sprain can be difficult for cutting and pivoting sports. Athletes should consider a functional ankle stabilization brace once cleared back to sports participation.


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