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Grades of high-ankle sprainsSyndesmotic (high) ankle sprain injuries take longer to heal than low-ankle ligamentous sprains. There are three grades to high-ankle sprains.
Grade 1 is a simple sprain and involves mild stretching of the ligaments.
Grade 2 is a moderate sprain and means the ligaments have partially and incompletely torn.
Grade 3 is a severe injury where the ligaments have completed ruptured, and in the case of syndesmotic injury there is associated diastasis at the ankle joint requiring surgical intervention.Distinct advantages
Tightrope’s quicker recovery has made it a very attractive procedure for surgeons and patients. I’ve had patients ask for the procedure because of its distinct advantages.
There are multiple manufacturers that have their own version of the tightrope. Essentially, these devices function as stable ligamentous complex while the patient’s torn ligaments heal. This allows patients to accelerate their rehabilitation with the end goal of returning to the activity or playing field in an expedited fashion.
The gold standard for these injuries has always been the use of rigid trans-syndesmotic screw fixation. The tightrope offers a viable alternative with a durable and flexible construct that allows early restoration of ankle stability, motion and function.
As with all surgical procedures there remain technical pearls to master. One pitfall during surgery is placing the tightrope with excessive tightness, and this would need to be addressed with a second operative procedure.
