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Ankle Instability

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International Advances in Foot and Ankle Surgery

Abstract

Ankle injuries are among the most commonly treated musculoskeletal injuries. In the United States, there are 23,000 ankle injuries each day, and the United Kingdom sees nearly 5,000.1,2 Within orthopedics, estimates place the incidence of ankle sprains between 10% and 25% of all musculoskeletal injuries.3,4 Of these, nearly 85% involve the lateral ankle complex.5 The sequelae of these injuries can be variable. Conservative management with functional rehabilitation can lead to good-to-excellent results in 70–85% of these injuries,6 but 20–40% will have persistent pain and instability.7,8

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References

  1. Karlsson J, Eriksson BI, Bergsten T, Rudholm O, Swärd L. Comparison of two anatomic reconstructions for chronic lateral instability of the ankle joint. Am J Sports Med. 1997;25(1):48-53.

    Article  PubMed  CAS  Google Scholar 

  2. van Rijn RM, van Os AG, Bernsen RM, Luijsterburg PA, Koes BW, Bierma-Zeinstra SM. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med. 2008;121(4):324-331.

    Article  PubMed  Google Scholar 

  3. Caprio A, Oliva F, Treia F, Maffulli N. Reconstruction of the lateral ankle ligaments with allograft in patients with chronic ankle instability. Foot Ankle Clin. 2006;11(3):597-605.

    Article  PubMed  Google Scholar 

  4. Kerkhoffs GMMJ, Handoll HHG, de Bie R, Rowe BH, Struijs PAA. Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults. Cochrane Database Syst Rev. 2008;2:1-66.

    Google Scholar 

  5. Ferran NA, Maffulli N. Epidemiology of sprains of the lateral ankle ligamentous complex. Foot Ankle Clin North Am. 2006;11:659-662.

    Article  Google Scholar 

  6. Kannus P, Renstrom P. Treatment for acute tears of the lateral ligaments of the ankle. Operation, cast or early controlled mobilization. J Bone Joint Surg Am. 1991;73(2):305-312.

    PubMed  CAS  Google Scholar 

  7. Ajis A, Maffulli N. Conservative management of chronic ankle instability. Foot Ankle Clin North Am. 2006;11:531-537.

    Article  Google Scholar 

  8. Sammarco GJ, DiRaimondo CV. Surgical treatment of lateral ankle instability syndrome. Am J Sports Med. 1988;16(5):501-511.

    Article  PubMed  CAS  Google Scholar 

  9. Pagenstert G, Leumann A, Hintermann B, Valderrabano V. Sports and recreation activity of varus and valgus ankle osteoarthritis before and after realignment surgery. Foot Ankle Int. 2008;29(10):985-993.

    Article  PubMed  Google Scholar 

  10. Burks RT, Morgan J. Anatomy of the lateral ankle ligaments. Am J Sports Med. 1994;22:72-77.

    Article  PubMed  CAS  Google Scholar 

  11. Colville MR, Marder RA, Boyle JJ, et al. Strain measurement in lateral ankle ligaments. Am J Sports Med. 1990;18:196-200.

    Article  PubMed  CAS  Google Scholar 

  12. Garrick JG. The Frequency of injury, mechanism of injury and epidemiology of ankle sprains. Am J Sports Med. 1977;5:241-242.

    Article  PubMed  CAS  Google Scholar 

  13. Espinosa N, Smerek J, Kadaka AR, Myerson MS. Operative management of ankle instability: reconstruction with open and percutaneous methods. Foot Ankle Clin North Am. 2006;11:547-565.

    Article  Google Scholar 

  14. Kerkhoffs GM, Rowe BH, Assendelft WJ, Kelly K, Struijs PA, van Dijk CN. Immobilization and functional treatment for acute lateral ankle ligament injuries in adults. Cochrane Database Syst Rev. 2002;3:CD003762.

    Google Scholar 

  15. Pijnenburg AC, Bogaard K, Krips R, Marti RK, Bossuyt PM, Dijk CN. Operative and functional treatment of rupture of the lateral ligament of the ankle: a randomized prospective trial. J Bone Joint Surg Br. 2003;85:525-530.

    Article  PubMed  CAS  Google Scholar 

  16. Brostrom L, Sprained Ankles VI. Surgical treatment of “chronic” ligament ruptures. Acta Chir Scand. 1966;132(5):551-565.

    PubMed  CAS  Google Scholar 

  17. Gould N, Seligson D, Gasman J. Early and late repair of the lateral ligament of the ankle. Foot Ankle. 1980;1(2):84-89.

    PubMed  CAS  Google Scholar 

  18. McBride DJ, Ramamurthy C. Chronic ankle instability: management of chronlic lateral ligamentous dysfunction and the varus tibiotalar joint. Foot Ankle Clin North Am. 2006;11:607-623.

    Article  Google Scholar 

  19. Boyer DS, Younger ASE. Anatomic reconstruction of the lateral ligamentous complex of the ankle using gracilis autograft. Foot Ankle Clin North Am. 2006;11:585-595.

    Article  Google Scholar 

  20. Colville MR, Grondel RJ. Anatomic reconstruction of the lateral ankle ligaments using a split peroneus brevis tendon graft. Am J Sports Med. 1995;23(2):210-213.

    Article  PubMed  CAS  Google Scholar 

  21. Sammarco GJ, Idusuyi OB. Reconstruction of the lateral ankle ligaments using a split peroneus brevis tendon graft. Foot Ankle Int. 1999;20(2):97-103.

    PubMed  CAS  Google Scholar 

  22. Berlet GC, Saar WE, Ryan A, Lee TH. Thermal-assisted capsular modification for functional ankle instability. Foot Ankle Clin. 2002;7:567-576.

    Article  PubMed  CAS  Google Scholar 

  23. Messer TM, Cummins CA, Ahn J, Kelikian AS. Outcome of the modified Broström procedure for chronic lateral ankle instability using suture anchors. Foot Ankle Int. 2000;21(12):996-1003.

    PubMed  CAS  Google Scholar 

  24. Snook GA, Chrisman OD, Wilson TC. Long-term results of the Chrisman-Snook operation for reconstruction of the lateral ligaments of the ankle. J Bone Joint Surg Am. 1985;67(1):1-7.

    PubMed  CAS  Google Scholar 

  25. Bell SJ, Mologne TS, Sitler DF, Cox JS. Twenty-six-year results after Broström procedure for chronic lateral ankle instability. Am J Sports Med. 2006;34(6):975-978.

    Article  PubMed  Google Scholar 

  26. Karlsson J, Bergsten T, Lansinger O, Peterson L. Reconstruction of the lateral ligaments of the ankle for chronic ankle instability. J Bone Joint Surg Am. 1988;70:581-588.

    PubMed  CAS  Google Scholar 

  27. Sugimoto K, Takakura Y, Akiyama K, Kamei S, Kitada C, Kumai T. Long-term results of Watson-Jones tenodesis of the ankle: clinical and radiographic findings after ten to eighteen years of follow-up. J Bone Joint Surg Am. 1998;80:1587-1596.

    Article  PubMed  CAS  Google Scholar 

  28. Kaikkonen A, Lehtonen H, Kannus P, Jarvinen M. Long-term functional outcome after surgery of chronic ankle instability: a 5 year follow-up of the modified Evans procedure. Scand J Med Sci Sports. 1999;9:239-244.

    Article  PubMed  CAS  Google Scholar 

  29. Espinosa N, Smerek JP, Myerson MS. Acute and chronic syndesmotic injuries: pathomechanisms, diagnosis and management. Foot Ankle Clin North Am. 2006;11:639-657.

    Article  Google Scholar 

  30. Williams GN, Jones MH, Amendola A. Syndesmotic ankle sprains in athletes. Am J Sports Med. 2007;35(7):1197-1207.

    Article  PubMed  Google Scholar 

  31. Xenos JS, Hopkinson WJ, Mulligan ME, Olson EJ, Popovic NA. The tibofibular syndesmosis: evaluation of the ligamentous structures, methods of fixation, and radiographic assessment. J Bone Joint Surg Am. 1995;77:847-856.

    PubMed  CAS  Google Scholar 

  32. Hopkinson WJ, St Pierre P, Ryan JB, Wheeler JH. Syndesmosis sprains of the ankle. Foot Ankle. 1990;10:156-160.

    Google Scholar 

  33. Zalavras C, Thordarson DB. Ankle syndesmotic injury. J Am Acad Orthop Surg. 2007;15:330-339.

    PubMed  Google Scholar 

  34. Forsythe K, Freedman KB, Stover MD, Patwardhan AG. Comparison of a novel FiberWire-button construct versus metallic screw fixation in a syndesmotic injury model. Foot Ankle Int. 2008;29(1):49-54.

    Article  PubMed  Google Scholar 

  35. Hintermann B, Knupp M, Pagenstert GI. Deltoid ligament injuries: diagnosis and management. Foot Ankle Clin. 2006;11(3):625-637.

    Article  PubMed  Google Scholar 

  36. Close JR. Some applications of the functional anatomy of the ankle joint. J Bone Joint Surg Am. 1956;38:761-781.

    PubMed  Google Scholar 

  37. Buman EM, Khazen G, Haraguchi N. Minimally invasive deltoid ligament reconstruction: a comparison of 3 techniques. Presented at: the annual meeting specialty day AOFAS, March 25, 2006; Chicago.

    Google Scholar 

  38. Deland JT, de Asla RJ, Segal A. Reconstruction of the chronically failed deltoid ligament: a new technique. Foot Ankle Int. 2004;25(11):795-799.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, USC Keck School of Medicine Surgery of the Foot and Ankle, 1520 San Pablo Street, Suite 2000, Los Angeles, CA, 90033, USA

    Timothy P. Charlton M.D.

  2. Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA

    Daniel R. Stephenson M.D. & David B. Thordarson M.D.

Authors
  1. Daniel R. Stephenson M.D.
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  2. Timothy P. Charlton M.D.
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  3. David B. Thordarson M.D.
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Correspondence to Timothy P. Charlton M.D. .

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Editors and Affiliations

  1. Department of Sports Medicine, PAFMG-Palo Alto Division, Clark Bldg., 3rd Flr 795 El Camino Real, Palo Alto, CA, 94301, USA

    Amol Saxena

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© 2012 Springer-Verlag London Limited

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Stephenson, D.R., Charlton, T.P., Thordarson, D.B. (2012). Ankle Instability. In: Saxena, A. (eds) International Advances in Foot and Ankle Surgery. Springer, London. https://doi.org/10.1007/978-0-85729-609-2_18

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  • DOI: https://doi.org/10.1007/978-0-85729-609-2_18

  • Publisher Name: Springer, London

  • Print ISBN: 978-0-85729-608-5

  • Online ISBN: 978-0-85729-609-2

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