Injury to the tibiofibular syndesmosis ligaments, which bind together the distal ends of the tibia and fibula, is commonly referred to as a high ankle sprain . While lateral ankle sprains are the most common injury, high ankle sprains represent a more disabling problem and require a longer recovery period  and different treatment . The mechanism associated with a high ankle sprain is primarily thought to involve external rotation of the foot [1,7]. However, both a cadaver study  and a simulation study  show that tibiofibular syndesmosis ligaments are not stretched the most during an excessive, pure external foot rotation.
- Bioengineering Division
Mechanism of Injury in a High Ankle Sprain: A Simulation Study
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Wei, F, Braman, JE, Meyer, EG, Powell, JW, & Haut, RC. "Mechanism of Injury in a High Ankle Sprain: A Simulation Study." Proceedings of the ASME 2011 Summer Bioengineering Conference. ASME 2011 Summer Bioengineering Conference, Parts A and B. Farmington, Pennsylvania, USA. June 22–25, 2011. pp. 79-80. ASME. https://doi.org/10.1115/SBC2011-53152
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