Syndesmotic ankle injuries in rodeo bull riders

This report describes five male rodeo bull riders, aged 18 to 32 years, who sustained syndesmotic ankle injuries during competition. The mechanism of injury was identical in each case. As the rider attempted to escape after being thrown, the bull stepped on his lateral ankle, resulting in forced external rotation. All patients delayed seeking medical care, the interval between the injury and presentation ranging from 2 days to 4 weeks. All five patients sustained significant syndesmotic tears, two with associated fibular fractures. Three patients underwent surgical stabilization, and all riders returned to competitive rodeo events, often prior to medical clearance. To the authors' knowledge, this is the first reported association between injuries caused by livestock stepping and syndesmotic disruptions.