Adding dynamic stability to lateral ligament reconstruction in ankle injuries
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 1
Abstract
Introduction: Ankle sprains involving the anterior talo-fibular ligament are one of the commonest injuries encountered in the day to day orthopaedic practice. Routinely these chronic instabilities are also initially treated non-operatively. Surgical intervention is required if the conservative treatment fails or in individuals demanding rapid return to athletic activities. The commonly performed surgeries for these injuries involve reconstruction of Anterior Talo-fibular ligament. We are describing a non anatomic technique using Semitendinosus graft for the reconstruction of lateral structures, including anterior talo-fibular and calcaneo-fibular ligament. Materials and Methods: A total of 6 patients who sustained trauma to their ankle more than 6 months prior to presentation in the form of an inversion injury came with complaints of pain and instability in the respective ankles. There was an increase in the lateral clear space with lateral tilt of talus on the radiograph. MRI scan showed loss of continuity of anterior talofibular ligament and bone marrow oedema in the dome of talus and anterior aspect of lower tibia. All patients were treated surgically using our technique. Results: The mean FAOS significantly improved from 33.63 points to 81.96 and VAS showed a decrease from 7.8 to 4.3 in 6 months. Conclusion: Our modification can enhance the lateral stability as two strands of the tendon control the inversion laxity. In this way our technique gives extra importance to the calcaneo-fibular ligament without reducing the strength of peroneus brevis muscle. At the same time we also ensure dynamic stability of the ankle by suturing the ATFL arm of the graft to peroneus brevis so that we recreate the normal gait mechanics. We found this study to give excellent results in subtalar instability and tibio-talar instability without any donor site morbidity.
Authors and Affiliations
Prashant Acharya, Arjun Naik
Keywords
Related Articles
- EP ID EP485342
- DOI 10.22271/ortho.2018.v4.i1h.77
- Views 123
- Downloads 0
Functional outcome of displaced fracture neck of femur in elderly treated by bipolar hemiarthroplasty versus total hip arthroplasty
With a reversing ageing pyramid and an increasing incidence of osteoporosis, hip fracture especially fracture neck of femur is an established public health concern globally. The purpose of this study is to analyze and co...
Clinical and functional outcomes of surgical management of distal femur fractures using distal femur locking compression plate
Distal femur fractures are reported to be less than 1% of all fractures and between 4 to 6 percent of all femoral fractures. Knowledge of anatomy of articular block with trapezoidal shape on axial section and anterior bo...
A prospective RCT comparing the outcome of above-knee and below-knee pop cast application for isolated tibial shaft fractures in children
Purpose: Above-Knee Cast has been standard treatment for treating tibial fractures in children. We conducted this study to evaluate the time of union, complication and cost of treatment between above- Knee and Below-Knee...
Role of Ilizarov ring fixator in definitive management of tibia shaft fractures: A prospective observational study of 50 cases
Introduction: Tibia shaft fractures can be treated with various modes, each having its merits and demerits. The aim of our study was to analyze clinical outcome of Ilizarov technique in patients with tibia shaft fracture...
Randomized controlled trial comparing open versus closed interlocking nail for closed fracture shaft of femur in Adults
Background: Close reduction and intramedullary fixation of fracture shaft femur proposed by Kuntscher, is the most biological way of treating the fracture shaft femur. But an open version of this procedure, by which the...