title: Chronic ankle instability.
abstract: Chronic instability of the ankle and anterolateral impingement syndrome are abnormalities that present as a result of inversion and forced plantar-flexion traumas of the foot, despite strict conservative management in the ER and in rehabilitation. A conservative approach is always the first choice of treatment, including anti-inflammatory medications, rehabilitation and proprioception, infiltration with steroids in impingement cases, and use of orthotics, whose true effectiveness is the subject of multiple studies and much debate. Good to excellent results can be obtained surgically with a minimally invasive approach, such as the arthroscopic technique presented herein. Such an approach is useful in managing a combination of conditions such as anterolateral impingement, synovitis, and osteochondral lesions of the talus. The method is easily reproducible, its learning curve is rapid, and it has the advantage of not preventing the use other arthroscopic methods, or open anatomic or nonanatomic methods (tendon transfers), in the case of failure. No nerve lesion was recorded, probably owing to the use of the security zone, and neither was there any arthrofibrosis, possibly related to the use of nonsteroidal anti-inflammatory medications in the immediate postsurgical period coupled with aggressive rehabilitation from the fourth week. The success of the technique is due to multidisciplinary team work leading to the ultimate achievement of patient satisfaction. This technique is not indicated for patients with a high sports demand or for sport professionals, until further biomechanical studies on its use and success are completed.
authors.affiliation: Centro Medico Imbanaco, Instituto de Enfermedades Osteoarticulars, Cali, Colombia. jbgerstner@imbanaco.com.co
authors.forename: Juan Bernardo
authors.initials: JB
authors.lastname: Gerstner Garces
mesh_terms: D016512:Ankle Injuries / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D002908:Chronic Disease; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D013180:Sprains and Strains / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy