This was traditionally done with the screws for a long time, especially if there are broken bones involved. Surgery entails placing hardware across from one leg bone to the other. If it widens with stress, it also may need surgery. An ankle joint that is widened from a syndesmosis injury can’t heal back in place on its own. If the bones appeared wider apart on x-ray, that is usually a much more significant injury than one that needs a higher tuned MRI to see. It’s rather important to note if anything was seen on the x-rays, because that could mean he needs surgery. When James was taken to the locker room, reports are that he received x-rays and an MRI. That’s why it’s called a “high” ankle sprain – it’s not by the foot, but higher up on the leg bones. This ligament runs up and down the leg below the knee to the ankle like a broad sheet and is called the syndesmosis. In his case, it wasn’t the ligaments that stabilize the ankle to the foot, but instead the ligaments that connect the two leg bones together. So when James rolled his ankle outward, he stretched or tore the ligaments in his ankle. The ACL in the knee is a well known example. It simply runs between bones to help stabilize a joint. A ligament, on the other hand, is like a tendon in its rope-like consistency, but it isn’t attached to a muscle. In order to pull a bone, the muscle transitions into a thick rope-like structure called a tendon that then inserts into the bone so that the body can move. Muscles are meaty structures but not very strong. A tendon is how a muscle attaches to the bone it needs to move. To understand what a high ankle sprain means, first it’s important to define the difference between a tendon and a ligament.
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