Diagnostic, Rehabilitation and Return-To-Play Guidelines of Syndesmotic Ankle Sprains in a Competitive Athletes: A Case Series.

Abstract

Syndesmotic ankle sprains, also known as high ankle sprains, are categorized as injury to the distal tibiofibular syndesmosis joint due to torsion at the ankle. The ligaments affected by this sprain includes the anterior inferior tibiofibular ligament, interosseous ligament and posterior inferior tibiofibular ligament. Recovery time for syndesmotic ankle sprains is reported to be much longer than lateral and medial ankle sprains. Syndesmotic ankle sprains are more prevalent in athletes participating in collision sports and in sports that immobilize the ankle in a boot, such as ice hockey. æIt is imperative that clinicians diagnose athletes with ankle pain correctly and provide efficient care to ensure that the athlete return-to-play in a timely manner. Correct diagnosis is often delayed and current literature does not provide a consistent rehabilitation plan and return-to-play guidelines. æThis case series presents three division I menÍs ice hockey athletes who experienced syndesmotic ankle sprains without ankle mortis diastasis or fracture. Player A, a 23 year old forward, was pinned against the boards by an opposing player causing external rotation and hyperdorsiflexion at his ankle, he returned to game play 38 days later. Player B, a 20 year old defenseman, was fallen on during a game and forcefully everted and externally rotated his ankle, he returned to game play 49 days later. Player C was pushed during a game, stepped on a stick and everted and externally rotated his ankle as he fell. Each athlete was diagnosed using the same method, followed similar rehabilitation protocols and return-to-play guidelines.