The treatment of chronic laxities of the ankle by external ligament tension restoration

  • El Hadj Souleymane CamaraEmail author
  • Abdoulaye Bousso
  • Jean Claude Sané
  • Mohamed Tall
Original Article


Chronic external laxities of ankle have long been treated by plasties with the short peroneal as stabilizer of the hindfoot. The restoration of the tension of the internal external capsule–ligament complex with a subastragalus flap is an interesting solution. Thirty-two sporting patients with an external instability of the ankle were treated surgically by restoration of the tension of the external lateral ligament using the Saragaglia technique and were re-examined with an average 5-year time lag. The instability and the anterior drawer were measured in pre and post-operative periods. If the intervention gives good results in severe external laxities, the result is definitely less good in laxities of low importance. The presence of a functional disorder of the forefoot constituted in the series a pejorative factor. The intervention makes it possible to correct external instability of the tibiotalar and subastragalus. The conservation of the axis of the hindfoot is useful for a good performance because an instability of the subastragalus deteriorates the result of the intervention.


Chronic laxity of the ankle External ligament tension restoration Subastragalus instability 


  1. 1.
    Castaing J, Le Cheballier P, Meunier M (1961) Entorse à répétition ou subluxation récidivante de la tibio-tarsienne. Une technique simple de ligamentoplastie externe. Rev Chir Orthop 47:598–608PubMedGoogle Scholar
  2. 2.
    Chrisman OD, Snook GA (1969) Reconstruction of lateral ligament tears of the ankle. An experimental study and clinical evaluation of seven patients treated by a new modification of the Elmslie procedure. J Bone Joint Surg 51A:904–912Google Scholar
  3. 3.
    Elmslie RC (1934) Recurrent subluxation of the ankle joint. Ann Surg 100:364–367PubMedCrossRefGoogle Scholar
  4. 4.
    Evans DL (1953) Recurrent instability of the ankle. A method of surgical treatment. Proc R Soc Med 46:343–344PubMedGoogle Scholar
  5. 5.
    Saragaglia D, Tourne Y, Picard F (1995) Instabilité chronique de la cheville et arthrose. Maitrise Orthopédique 44:1–10Google Scholar
  6. 6.
    Ahlgren O, Larsson S (1989) Reconstruction for lateral ligament injury of the ankle. J Bone Joint Surg 71B:300–303Google Scholar
  7. 7.
    Duquennoy A, Fontaine C, Martinot JC, Bosquet F, Sion S (1989) Instabilité chronique de l’articulation tibio-tarsienne remise en tension ligamentaire externe. A propos de 58 cas revus. Rev Chir Orthop 75:387–393Google Scholar
  8. 8.
    Christel P, Witvoet J, Jaulin P (1988) Traitement chirurgical des instabilite tibio-tarsiennes chroniques chez le sportif par retension transosseuse du plan ligamentaire externe. J Traumatol Sport 5:177–184Google Scholar
  9. 9.
    Gould N, Seligson D, Gassman J (1980) Early and late repair of lateral a ligament of the ankle. Foot Ankle 1:84–89PubMedGoogle Scholar
  10. 10.
    Johannsen A (1978) Radiological diagnosis of lateral ligament lesion of the ankle. Acta Orthop Scand 49:295–301PubMedCrossRefGoogle Scholar
  11. 11.
    Brostrom L (1966) Sprained ankles. VI Surgical treatment of chronic ligament ruptures. Acta Chir Scand 32:551–565Google Scholar
  12. 12.
    Blanchet A (1975) La refection capsuloqigamentaire dans les instabilites chroniques de la tibio-tarsienne. Rev Chir Orthop 61(suppl II):175–176PubMedGoogle Scholar
  13. 13.
    Roy-Camille R, Saillant G, Gagna G, Benazet JP, Feray Ch (1986) Les laxités externes chroniques de cheville. Cure chirurgicale par une ligamentoplastie au périoste. Rev Chir Orthop 72:121–126PubMedGoogle Scholar
  14. 14.
    Sjølin SU, Dons-Jensen H, Simonsen O (1991) Reinforced anatomical reconstruction of the anterior talofibular ligament in chronic anterolateral instability using a periosteal flap. Foot Ankle 12(1):15–18PubMedGoogle Scholar
  15. 15.
    Saragaglia D, Fontanel F, Montbarbon E, Tourné Y, Picard F, Charbel A (1997) Reconstruction of the lateral ankle ligaments using an inferior extensor retinaculum flap. Foot Ankle Int 18(11):723–728PubMedGoogle Scholar
  16. 16.
    Nq ZD, Das De S (2007) Modified Brostrom-Evans-Gould technique for recurrent lateral ankle ligament instability. J Orthop Surg (Hong Kong) 15(3):306–310Google Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • El Hadj Souleymane Camara
    • 1
    • 2
    Email author
  • Abdoulaye Bousso
    • 1
  • Jean Claude Sané
    • 3
  • Mohamed Tall
    • 4
  1. 1.Chirurgien au service d’orthopédie et de traumatologiel’Hôpital Général de Grand YoffDakarSenegal
  2. 2.Université cheikh anta diopDakarSenegal
  3. 3.Chirurgien orthopédisteHôpital Général de Grand YoffDakarSenegal
  4. 4.Interne des hôpitaux au service d’orthopédie et de traumatologiel’Hôpital Général de Grand YoffDakarSenegal

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