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More Than "Just a Sprain"

Ankle Sprains and Fractures, Diagnosed Right the First Time

Here's the uncomfortable truth about "just a sprain": some of the most damaging injuries I treat walked around for weeks with that label. High ankle sprains that were unstable syndesmosis injuries. "Sprains" that were Lisfranc injuries, stress fractures, tendon tears, or cartilage lesions. The ankle that's still swollen, unstable, or painful weeks later isn't asking for more rest — it's asking for a diagnosis.

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By Victor R. Prisk, MD, FAAOS — Board-Certified Orthopaedic Surgeon, Foot & Ankle Fellowship (HSS) · Last updated August 2026

At a Glance

Best for
New & stubborn ankle injuries
Imaging
X-ray + weight-bearing CT on-site
High ankle sprains
Arthroscopic TightRope
Fractures
Early weight-bearing protocols
Work injuries
WC accepted; IMEs provided
Evaluation
Same-week

One Visit

Get the Right Answer the First Time

At our Monroeville office the workup happens in one place, usually in one visit:

Digital X-rays on-site

Fractures and alignment, immediately.

Weight-bearing CT

The standing scan that reveals subtle fractures, syndesmosis widening, and true alignment that tabletop imaging misses.

Diagnostic ultrasound

Ligaments and tendons, evaluated dynamically.

A specialist's exam

Squeeze and external-rotation tests for high ankle sprains; direct ligament and tendon testing.

Sorting sprain from break from "something in between" is exactly what fellowship training is for. Primer: Is it a sprain, a break, or something in between?

Sprains

Treat It Right or Meet It Again

Most sprains heal — when they're rehabbed, not just rested. My protocol pairs early protected motion with progressive balance and strength work through our on-site P.O.W.ER physical therapy team, because the number-one cause of chronic ankle instability is the sprain that was never rehabilitated. If your ankle still gives way months later, that's a ligament problem with a real fix: the Broström-Gould reconstruction.

High ankle sprains are their own animal. When the syndesmosis — the ligament complex binding tibia to fibula — is unstable, I stabilize it arthroscopically with the TightRope technique: flexible, anatomic fixation that lets athletes move sooner than old-school rigid screws. How TightRope works.

Red Flags

Get Imaged If…

  • You can't bear weight
  • Bony tenderness at the ankle or midfoot
  • Not clearly improving within days
  • A "sprain" still swollen at 2–3 weeks

Fractures

Fixed for Function, Not Just X-rays

From malleolar fractures to fifth metatarsals, Lisfranc injuries, and calcaneus fractures, my priorities are anatomic fixation and getting you moving as early as the repair safely allows — modern evidence favors early protected weight-bearing over months of needless immobilization, and muscle you don't lose is rehab you don't need. Why early weight-bearing matters.

When a fracture involves the joint surface, I address cartilage damage at the same time — see ankle cartilage repair.

Work Injuries

Hurt on the Job? Seen Fast.

Work injuries are a huge share of ankle fractures and sprains. We treat workers' compensation cases, see injured workers promptly, and provide independent medical examinations.

  • Fellowship-trained at the Hospital for Special Surgery
  • X-ray, weight-bearing CT, ultrasound, bracing, and PT under one roof
  • Independent practice — operating privileges at both AHN and UPMC facilities

Employers & Adjusters

Direct scheduling for work-injury evaluations, clear documentation, and expert medicolegal opinions. Call (412) 525-7692.

The Comeback

Recovery, Not Just Rest

  1. Diagnosis & protection

    Imaging done, plan made, protected in the right device — not just an air cast and a shrug.

  2. Early protected motion

    When the injury (or repair) allows, motion and protected weight-bearing start early.

  3. Strength & balance

    Progressive rehab with the on-site P.O.W.ER team — the phase most "just a sprain" plans skip.

  4. Return & prevent

    Graded return to sport or work, with the balance and strength work that prevents the next one.

Questions Patients Ask

Sprains & Fractures, Answered

How do I know if my ankle is sprained or broken?
You often can't — that's the honest answer. Ability to walk on it doesn't rule out a fracture, and severe pain doesn't confirm one. If you can't bear weight, have bony tenderness, or aren't clearly improving within days, get imaged.
What is a high ankle sprain?
An injury to the syndesmosis, the ligaments binding your two leg bones together above the ankle. It heals slower than a regular sprain and, when unstable, needs surgical stabilization — I use the arthroscopically-assisted TightRope technique.
Do I really need to see a specialist for a sprain?
For a first mild sprain that improves on schedule — probably not. For a sprain that's severe, recurrent, or not clearly better in 2–3 weeks, yes: the "sprains" that turn out to be tendon tears, cartilage injuries, or Lisfranc injuries are the ones that cost seasons when missed.
How soon can I walk after ankle fracture surgery?
Earlier than tradition says. When fixation is solid, I favor early protected weight-bearing — supported by modern evidence — rather than months of immobilization. Your written protocol depends on your fracture pattern and repair.
Is this covered by insurance?
We are in-network with Highmark/BCBS, UPMC, Aetna, Cigna, United, most Medicare plans, and others. Call the office to confirm your specific plan.

Prisk Orthopaedics and Wellness

Injured? Don't Guess.

Same-week evaluation with imaging on-site. Know what it is — then fix it properly.

Request an AppointmentCall (412) 525-7692

2490 Mosside Blvd, Monroeville, PA 15146  ·  Serving Pittsburgh, Monroeville, Murrysville, Plum, Penn Hills & Greensburg  ·  Insurance accepted