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Lateral Ankle Instability pp 315–331Cite as

Lower Extremity Alignment and Ankle Instability

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Abstract

Lesions of the lateral ligament complex of the ankle is one of the most frequent sports-related injuries. Chronic lateral instability develops as a sequel in almost 30% of these patients.

A lot of techniques by arthroscopic or open surgery have been described during the last years in order to treat these disorders.

The good and excellent results of these techniques in patients with mild, moderate, or severe ankle instability are well known, but many patients present severe chronic ankle instability associated with post-traumatic and idiopathic cavovarus deformity on whom conservative and orthopedic treatment failed to provide acceptable results.

In these cases even if the ligament is repaired, the patients will develop an ankle osteoarthritis (OA) if the malalignment is not corrected.

Supramalleolar, inframalleolar osteotomies, or the combination of both could be an acceptable alternative.

The goal of supramalleolar or inframalleolar osteotomies is to realign the low extremity deformity and to redistribute the loads on the ankle joint, improving the biomechanics of the lower limb.

In this chapter, we describe the technique of each one of these alternatives, combination, indications, and contraindications.

Endoscopic ankle ligament repair associated with inframalleolar or supramalleolar osteotomies may be an effective surgical option for severe chronic ankle instability associated with tibial or calcaneous varus deformity. Correcting alignment, restoring stability, and reducing pain allows patients to walk and run properly resulting in higher quality of life.

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Authors and Affiliations

  1. Centro Artroscópico Jorge Batista SA, AV. Pueyrredon 2446 First Floor, Buenos Aires, Argentina

    Jorge Pablo Batista

  2. Professional Soccer Department Club Atlético Boca Juniors, CABA, Buenos Aires, Argentina

    Jorge Pablo Batista

  3. Ripoll y De Prado Sports Clinic: FIFA Medical Centre of Excellence, Murcia-Madrid, Spain

    Hélder Pereira

  4. Orthopaedic Department, Centro Hospitalar Póvoa de Varzim, Vila do Conde, Portugal

    Hélder Pereira

  5. ICVS/3B’s – PT Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal

    Hélder Pereira

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  1. Jorge Pablo Batista
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Editors and Affiliations

  1. Póvoa de Varzim-Vila do Conde Hospital Centre, Minho university, Braga-Guimarães, Portugal

    Hélder Pereira

  2. SOS Pied Cheville Bordeaux, Bordeaux-Mérignac, France

    Stéphane Guillo

  3. Queen Elizabeth II Health Sciences Center & Dalhousie University, Halifax, NS, Canada

    Mark Glazebrook

  4. Clinical and Research Institute for Foot and Ankle Surgery, Jujo Hospital, Kisarazu, Chiba, Japan

    Masato Takao

  5. Imperial College London and Fortius Clinic London, London, UK

    James Calder

  6. FIFA Medical centre of excellence Madrid and Porto, Department of Orthopaedic Surgery, University of Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands

    Niek Van Dijk

  7. Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden

    Jón Karlsson

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Batista, J.P., Pereira, H. (2021). Lower Extremity Alignment and Ankle Instability. In: Pereira, H., et al. Lateral Ankle Instability. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62763-1_36

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