High ankle sprains involve a ligamentous injury slightly above the ankle joint. There are two long bones, tibia and fibula, that together form a stable surface connection for which the ankle can move on. The stability of this joint is crucial for the function of the ankle and its ability to withstand weightbearing activities.
This injury can appear similar to the more common lateral ankle sprain. However, it is more of an external rotation movement of the foot when it is planted which commonly leads to a high ankle sprain. With enough force, these injuries can also cause fractures or dislocations. It is important to distinguish a high ankle sprain from a lateral ankle sprain since the appropriate treatment will be different. Delayed treatment can cause complications in the future if not addressed and managed effectively.
Symptoms generally include pain and swelling in front of the ankle, a sensation of instability, difficultly with or unable to walk, or unable to perform a single leg heel raise.
Depending on the severity of the injury, it may either need conservative treatment or surgery with follow-up rehabilitation. One of the critical factors will be if the distal tibiofibular joint is stable or unstable which can be confirmed with imaging investigations.
It is important to determine the correct diagnosis early on to establish an appropriate recovery plan.