Sideline Management of Syndesmotic Injuries in the Athlete: Evaluation, Management, and Return to Play

Objective: This review aims to provide a comprehensive examination of syndesmotic ankle injuries in athletes, covering pertinent aspects from anatomy to treatment options. Methods: A thorough literature search was conducted to gather relevant information on syndesmotic injuries in athletes. Data regarding anatomy, epidemiology, injury mechanisms, clinical assessment, imaging modalities, conservative management, and surgical interventions were analyzed and synthesized. Results: Syndesmotic injuries, colloquially termed high ankle sprains, pose significant challenges for medical professionals, especially in high-impact sports such as American football. Clinical evaluation, including specific tests and imaging techniques, is crucial for accurate diagnosis. Conservative management strategies involve immobilization and rehabilitation for stable injuries, while surgical intervention may be necessary for severe cases to maintain anatomic alignment. Various surgical techniques, including screw and suture button fixation, have been utilized with favorable outcomes. Discussion/conclusion: A comprehensive understanding of syndesmotic injuries is essential for health care providers involved in the care of athletes. Accurate diagnosis, tailored treatment plans, and appropriate rehabilitation protocols are vital for optimizing outcomes and facilitating safe return to sport. This review serves as a valuable resource for clinicians managing syndesmotic injuries in athletes, highlighting the importance of evidence-based approaches in guiding clinical decision-making. Patient consent disclosure statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.