Reverse Evans peroneus brevis medial ankle stabilization for balancing valgus ankle contracture during total ankle replacement.
Medial ankle instability secondary to deltoid ligament insufficiency is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, we describe a "reverse" Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction for medial ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis tendon is brought through a drill hole in the talus from laterally to medially, aiming for the junction of the talar neck and body plantar to the midline. The tendon is the brought superiorly and obliquely to the anterior medial aspect of the distal tibia where it is secured under a plate and screw construct. This modified Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction is useful in providing medial ankle stability during or after primary and revision total ankle replacement.
Attending Staff, Department of Orthopaedics, Podiatry, and Sports Medicine, Gundersen Health System, La Crosse, WI. Electronic address: tsroukis@gundersenhealth.org.
Thomas S
TS
Roukis
Postgraduate Year III Resident, Podiatric Medicine and Surgery Residency Program, Gundersen Medical Foundation, La Crosse, WI.
Mark A
MA
Prissel
D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D058737:Arthroplasty, Replacement, Ankle; D003286:Contracture / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery; D011859:Radiography; D013709:Tendon Transfer / Q000379:methods*
ankle prosthesis; complications; deformity; musculotendinous imbalance; total ankle arthroplasty