The Effect of “High-ankle Sprain” Taping on Ankle Syndesmosis Congruity: A Cadaveric Study

Stéphanie Lamer1, 2, Jonah Hébert-Davies1, 4, Vincent Dubé1, 2, Stéphane Leduc1, 2, Émilie Sandman1, 2, Jérémie Ménard1, Marie-Lyne Nault1, 2, 3, *
1 Hôpital du Sacré-Coeur de Montréal, 5400 Boul. Gouin O, Montreal, QC H4J 1C5, Canada
2 Department of Surgery, Université de Montréal, 2900 Boul. Edouard-Montpetit, Montreal, QC H3T 1J4, Canada
3 CHU Sainte-Justine, 7905-3175 Côte Ste-Catherine, Montréal, QC H3T 1C5, Canada
4 Harborview Medical Center, 325 9th Ave, Seattle, WA 98104, USA

© 2020 Lamer et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the CHU Sainte-Justine, 7905-3175 Côte Ste-Catherine, Montréal, QC. Canada, H3T 1C5., Canada; E-mail:



Different treatment options exist for dynamically unstable purely ligamentous syndesmotic injury, including surgery, walking boot, brace and taping.


The main purpose of this study was to evaluate the effect of high-ankle sprain taping (ring taping) on syndesmotic stability in various ligament conditions when axial loading is applied.


This controlled cadaveric laboratory study included ten cadaveric specimens installed in a custom-made device applying 750N of axial loading in order to simulate weight-bearing. Sectioning of syndesmotic ligaments, AiTFL and IOL, was done sequentially and CT scan images were taken with and without high-ankle sprain taping. A validated measurement system consisting of 3 lengths and 1 angle was used. Results were compared with Wilcoxon tests for paired samples and non-parametric data.


In every ligament condition (intact vs. cut), no statistically significant difference was observed between specimens, with or without high-ankle sprain taping and with or without axial loading. When the data from ankles with AiTFL and IOL ruptures were compared, the mean for length “b” without axial loading was 7.19 (±2.17), compared to 7.20 (±1.98) with axial loading (p-value = 0.905). With taping and the leg still in axial loading, the value was 7.17 (±2.09) (p-value = 0.721), which is not statistically significant.


It is impossible to conclude regarding high-ankle sprain taping’s capacity to maintain syndesmosis congruity because no significant difference was observed, regardless of condition. The most important finding is that high-ankle sprain taping did not cause malreduction of the injured syndesmosis.

Level of Evidence:

Level V cadaveric study

Keywords: Syndesmosis, High-ankle sprain taping, Ring tape, Weight-bearing, Ligament condition, Axial loading.