Prognosis
Figure 13: X-ray: ossification of interosseous membrane, 4 months post injury (9).
There are many factors which influence the return to normal function post ankle syndesmosis injury (20). Generally, recovery from ankle syndesmosis injuries is of greater duration than lateral ankle strains, and requires a greater number of treatments (9).
Estimation of the time taken to retun full activity/sports varies in the literature, but ranges from 45 days (23) to 10 weeks (4). Of great concern is the prevalence of long term dysfunction. Many follow up studies of both surgical and non-surgical ankle syndesmosis injuries with imaging show ossification of the interosseous membrane (4). Some patients experience little disability despite having evidence of ossification (9), however many experience ongoing pain and instability. Despite this, most patienst appear to continue to participate in sports, and are not sufficiently limited by symptoms to cease physical activity.
For the therapist, ensuring good prognosis is a combination of sufficient mobilisation and ambulation post injury, and sufficient strength and proprioceptive training to allow a return to pain-free physical activity.
Estimation of the time taken to retun full activity/sports varies in the literature, but ranges from 45 days (23) to 10 weeks (4). Of great concern is the prevalence of long term dysfunction. Many follow up studies of both surgical and non-surgical ankle syndesmosis injuries with imaging show ossification of the interosseous membrane (4). Some patients experience little disability despite having evidence of ossification (9), however many experience ongoing pain and instability. Despite this, most patienst appear to continue to participate in sports, and are not sufficiently limited by symptoms to cease physical activity.
For the therapist, ensuring good prognosis is a combination of sufficient mobilisation and ambulation post injury, and sufficient strength and proprioceptive training to allow a return to pain-free physical activity.
