title: Chronic, painful ankle instability in skeletally immature athletes. Ununited osteochondral fractures of the distal fibula.
abstract: We report 10 cases of chronic, painful ankle instability in skeletally immature athletes associated with ununited osteochondral fragments of the distal fibula. All the patients experienced multiple inversion injuries with recurrent pain and instability that failed to improve after a supervised exercise and rehabilitation program. Osteochondral fragments of the distal fibula were visible on all standard radiographs of the affected ankles. Treatment consisted of operative excision of the bony fragment and an anatomic nonaugmented repair of the lateral ligament complex and capsule. All 10 patients were available for long-term followup an average of 6.5 years (+/-2) after surgery; all ankles improved functionally, with no recurrences of instability.
authors.affiliation: Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical Center, Worcester 01655, USA.
authors.forename: B D
authors.initials: BD
authors.lastname: Busconi
authors.forename: A M
authors.initials: AM
authors.lastname: Pappas
mesh_terms: D000293:Adolescent; D016512:Ankle Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000209:etiology*; D001265:Athletic Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D002356:Cartilage / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D002648:Child; D002908:Chronic Disease; D017885:Collateral Ligaments / Q000293:injuries / Q000601:surgery; D005081:Exercise Therapy; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005500:Follow-Up Studies; D005599:Fractures, Ununited / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology*; D008137:Longitudinal Studies; D008297:Male; D011859:Radiography; D012008:Recurrence; D013180:Sprains and Strains / Q000209:etiology