title: The anterior talo-fibular ligament reconstruction in surgical treatment of chronic lateral ankle instability.
abstract: Chronic lateral ankle instability causes significant problems in physical activity and accelerates development of osteoarthritic changes. The results of treatment for chronic ankle instability are often meets controversial. A surgical reconstruction of ATFL as described in this paper was performed during the period 1997-2005 on 47 patients (26 male, 21 female), with a mean age of 29.3 years. The average follow-up period was 46.2 months. All patients had clinical examination, X-ray and MRI. The mean values of the Good score improved from an average 3.32 prior to surgery to 1.19 one year after the operation. Paired t-tests showed improvements of great significance (p < 10(-28)). The Good score prior to surgery ranged from 2-4, whereas the scores one year after surgery were either 1 or 2, with a score of 1 being recorded in 38 cases (81%). In the postoperative follow-up, MRI showed a newly-formed ligament structure in all cases. The authors describe their own technique for a reconstruction of lateral ankle instability using remnants of the former ATFL. The scar tissue seems to be sufficient to form a new duplicated structure providing good stability. MRI proved to be a sensitive and specific method for identifying the extent of talo-fibular ligament injury.
authors.affiliation: Department of Orthopaedic Surgery, 2nd Medical Faculty, Charles University Prague, V Uvalu 84, Prague 5, Czech Republic. tomas.trc@fnmotol.cz
authors.forename: Tomás
authors.initials: T
authors.lastname: Trc
authors.forename: Milan
authors.initials: M
authors.lastname: Handl
authors.forename: Vojtech
authors.initials: V
authors.lastname: Havlas
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D000843:Ankle Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017844:Lateral Ligament, Ankle / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D055815:Young Adult