Reconstruction of the lateral ankle ligaments with hamstring tendon autograft in patients with chronic ankle instability.
Summary of "Reconstruction of the lateral ankle ligaments with hamstring tendon autograft in patients with chronic ankle instability."
OBJECTIVE:
Reconstruction of the anterior talofibular (ATFL) and calcaneofibular (CFL) ligament in patients with chronic lateral ankle instability.
INDICATIONS:
Symptomatic chronic lateral ankle instability.
CONTRAINDICATIONS:
Bony malalignment, advanced arthritic changes of the ankle joint, diabetic foot syndrome. SURGICAL
TECHNIQUE:
Reconstruction of the ATFL and CFL with a free gracilisor or semitendinosus tendon graft through a V-shaped tunnel at the insertion site of the ATFL on the talar neck as well as a transfibular tunnel directed anterior to posterior through the fibula tip to a blind ending tunnel in the calcaneus at the insertion site of the CFL. Insertion of the graft through the talar tunnel, passing both graft ends through the fibular tunnel to the calcaneus. Fixation with a bioabsorbable screw. POSTOPERATIVE
MANAGEMENT:
Short leg cast for 10-14 days and partial weight-bearing. Afterwards ankle brace for 6 weeks and functional physical therapy.
RESULTS:
From December 2003 to August 2005, reconstruction of the ATFL and CFL with a hamstring tendon autograft was performed in 20 patients with chronic lateral instability of the ankle joint. All patients were evaluated after a mean follow-up time of 1.8 years (15-36 months). Clinical evaluation referred to the AOFAS score. Stress radiography was performed for objective assessment of lateral ankle stability. Postoperatively 19 of 20 patients reported good subjective stability with no further ankle sprains. The mean postoperative AOFAS score was 92 of 100 points (72-100). Stress radiography showed a significant reduction of both lateral ankle instability and talar tilt.
Affiliation
Zentrum für Arthroskopie und spezielle Gelenkchirurgie, Klinik für Sportorthopädie und arthroskopischen Chirurgie der Orthopädischen Klinik Markgröningen, Kurt Lindemannweg 10, 71706, Markgröningen, Deutschland, j.richter@okm.de.
Journal Details
This article was published in the following journal.
Name: Operative Orthopadie und Traumatologie
ISSN: 1439-0981
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22270880
- DOI: http://dx.doi.org/10.1007/s00064-011-0126-7
Medical and Biotech [MESH] Definitions
Bone-patellar Tendon-bone Graft
Fixation of the ANTERIOR CRUCIATE LIGAMENT, during surgical reconstruction, by the use of a bone- patellar tendon autograft.
Lateral Ligament, Ankle
There are two lateral ligaments of the ankle - internal and external. The internal lateral ligament is attached to the apex and anterior and posterior bodies of the inner malleolus and inserted into the navicular bone, the inferior calcaneo-navicular ligament, the sustentaculum tali of the os calcis, and the inner side of the astragalus. The external lateral ligament, also called the lateral collateral ligament, consists of three distinct fasciculi - the calcaneofibular, the anterior talofibular, and the posterior talofibular.
Posterior Tibial Tendon Dysfunction
A condition characterized by a broad range of progressive disorders ranging from TENOSYNOVITIS to tendon rupture with or without hindfoot collapse to a fixed, rigid, FLATFOOT deformity. Pathologic changes can involve associated tendons, ligaments, joint structures of the ANKLE, hindfoot, and midfoot. Posterior tibial tendon dysfunction is the most common cause of acquired flatfoot deformity in adults.
Tenosynovitis
Inflammation of the synovial lining of a tendon sheath. Causes include trauma, tendon stress, bacterial disease (gonorrhea, tuberculosis), rheumatic disease, and gout. Common sites are the hand, wrist, shoulder capsule, hip capsule, hamstring muscles, and Achilles tendon. The tendon sheaths become inflamed and painful, and accumulate fluid. Joint mobility is usually reduced.
Tendon Entrapment
Narrowing or stenosis of a tendon's retinacular sheath. It occurs most often in the hand or wrist but can also be found in the foot or ankle. The most common types are DE QUERVAIN DISEASE and TRIGGER FINGER DISORDER.
PubMed Articles
Anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft.
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