Anatomical reconstruction of chronic lateral ligament injury of the ankle using pedicle tendon of the extensor digitorum longus.
BACKGROUND
Since 1989, we have performed ligament reconstruction using the extensor digitorum longus tendon as a pedicle graft for patients with chronic lateral instability of the ankle.


METHODS
Of those patients who underwent arthroscopy during the operation, thirteen joints were evaluated at an average follow-up of 7 years and 2 months. The overall average postoperative score was 95.4 points on Karlsson's score for the ankle ligament. Instability scores improved by 8.5-24.6 points. Our anatomical reconstructive surgery showed generally excellent functional results, with cosmetic advantages because of a short incision and preservation of the entire peroneus brevis tendon, which plays an important role in extra-articular dynamic stabilization.


RESULTS
At final follow-up, pain was present in one joint in the group without chondral injury at the time of reconstruction ( n=6). However, pain was still present at the final follow-up in five of the group with chondral injury ( n=7). Chondral injury incurred during ligament reconstruction may have caused the residual ankle pain even after 7 years of postoperative follow-up. There was a statistically significant relationship between chondral injury and ankle pain at final follow-up.
Department of Orthopaedic Surgery, Kochi Medical School, 783-8505, Kochi, Japan. takahast@kochi-ms.ac.jp
Toshiaki
T
Takahashi
Masato
M
Nakahira
Kuninobu
K
Kaho
Teruhiko
T
Kawakami
D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015601:Injury Severity Score; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery; D017844:Lateral Ligament, Ankle / Q000293:injuries / Q000601:surgery*; D008297:Male; D018482:Muscle, Skeletal; D011859:Radiography; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome