What mechanism of injury is most likely to cause a syndesmotic ankle injury during a football game?

• A. Forced dorsiflexion with rotation
• B. A direct blow to the lateral knee with external rotation of the foot
• C. Inversion injury of the ankle
• D. High ankle sprain without contact

Answer: (B)

The most likely mechanism of injury to cause a syndesmotic ankle injury is forced dorsiflexion with rotation. This type of injury occurs when there is excessive movement between the tibia and fibula due to external forces. In football, when a player’s foot is dorsiflexed and simultaneously rotated, it can place a significant strain on the syndesmosis, which is the fibrous joint that binds the two bones together.

Syndesmotic injuries, commonly referred to as "high ankle sprains," typically result from movements that involve both external rotation of the foot and dorsiflexion. This can happen when a player's foot is caught while the leg is twisted, a scenario often encountered during tackling or when being tackled.

On the other hand, while a direct blow to the lateral knee with external rotation of the foot can certainly lead to various knee injuries, it is not the primary mechanism attributed to syndesmotic injuries. Inversion injuries primarily affect the lateral ankle structures, such as the lateral ligaments, and do not involve the syndesmosis directly. The term "high ankle sprain without contact" refers to the injury when no physical contact occurs, which often doesn't generate enough force to disrupt the syndesmosis.

Thus