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First published on May 22, 2007, doi:10.1177/0363546507302545
This version was published on July 1, 2007
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The American Journal of Sports Medicine 35:1197-1207 (2007)
© 2007 American Orthopaedic Society for Sports Medicine

Clinical Sports Medicine Update

Syndesmotic Ankle Sprains in Athletes

Glenn N. Williams, PT, PhD, ATC*,{dagger},{ddagger}, Morgan H. Jones, MD§ and Annunziato Amendola, MD*,{dagger},{ddagger},||

From the * Graduate Program in Physical Therapy and Rehabilitation Science, University of Iowa Hospitals and Clinic, Iowa City, Iowa, {dagger} University of Iowa Sports Medicine Center, University of Iowa Hospitals and Clinic, Iowa City, Iowa, {ddagger} Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, and § Department of Orthopaedics, Cleveland Clinic Foundation, Cleveland, Ohio

|| Address correspondence to Annunziato Amendola, MD, Department of Orthopaedics & Rehabilitation, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52242 (e-mail: ned-amendola{at}uiowa.edu).

Ankle sprains are among the most common athletic injuries and represent a significant source of persistent pain and disability. Despite the high incidence of ankle sprains in athletes, syndesmosis injuries have historically been underdiagnosed, and assessment in terms of severity and optimal treatment has not been determined. More recently, a heightened awareness in sports medicine has resulted in more frequent diagnoses of syndesmosis injuries. However, there is a low level of evidence and a paucity of literature on this topic compared with lateral ankle sprains. As a result, no clear guidelines are available to help the clinician assess the severity of injury, choose an imaging modality to visualize the injury, make a decision in terms of operative versus nonoperative treatment, or decide when the athlete may return to play. Increased knowledge and understanding of these injuries by clinicians and researchers are essential to improve the prevention, diagnosis, and treatment of this significant condition. This review will discuss the anatomy, mechanism of injury, diagnosis, and treatment of syndesmosis sprains of the ankle while identifying controversies in management and topics for future research.

Key Words: syndesmosis • anterior inferior tibiofibular ligament • sports injury • rehabilitation






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