About the condition
The syndesmosis is the ligament complex linking the tibia and fibula near the ankle. Injury may occur with a sprain or fracture, and the key question is whether the ankle remains stable.
Treatment options
Suspected syndesmosis injury warrants a clear assessment and a plan for protection. An apparently mild injury should not automatically follow a standard lateral sprain programme.
Surgical considerations
Unstable injuries may need reduction and fixation. Screw or other fixation choices and associated fractures affect the plan. Confirm loading restrictions and whether further procedures are expected.
Rehabilitation principles
Rehabilitation must respect the prescribed protection phase. Once cleared, work towards ankle movement, walking and progressive strength before higher-demand tasks.
Recovery expectations
The next step should be explicit: what is allowed, what remains restricted and when reassessment is due. Recovery varies with stability, fixation and associated injury; pain alone cannot confirm healing.
Evidence context
AO guidance explains syndesmosis fixation and protection. It is a surgical reference, not evidence that one rehabilitation schedule suits all high ankle sprains.
Research & guidance
Evidence sources checked: 2026-10-11.
Editorial draft — HK+A clinical review pending.