Chronic ankle instability: Current perspectives

Omar A Al-Mohrej, Nader S Al-Kenani, Omar A Al-Mohrej, Nader S Al-Kenani

Abstract

Ankle sprain is reported to be among the most common recurrent injuries. About 20% of acute ankle sprain patients develop chronic ankle instability. The failure of functional rehabilitation after acute ankle sprain leads to the development of chronic ankle instability. Differentiation between functional and anatomical ankle instability is very essential to guide the proper treatment. Stability testing by varus stress test and anterior drawer test should be carried out. Subtalar instability is an important pathology that is commonly by passed during the assessment of chronic ankle instability. Unlike acute ankle sprain, chronic ankle instability might require surgical intervention. The surgical and conservative management options can be very much developed by in-depth knowledge of the ankle anatomy, biomechanics, and pathology. Anatomical repair, augmentation by tendon, or both are the basic methods of surgical intervention. Arthroscopy is becoming more popular in the management of chronic ankle instability.

Keywords: Etiology; ankle; chronic instability; diagnosis; surgical techniques.

Figures

Figure 1
Figure 1
The lateral ligamentous components of the ankle joint
Figure 2
Figure 2
(a) Sagittal and (b) coronal views of magnetic resonance imaging showing osteochondral defects of the talus
Figure 3
Figure 3
Peroneal tendinopathy. (a) Peroneal tenosynovitis. (b) Longitudinal tear of the peroneal brevis tendon
Figure 4
Figure 4
Standard surgical approach
Figure 5
Figure 5
Primary repair. (a) Identification and suturing of the torn ligament. (b) End-to-end repair on tension
Figure 6
Figure 6
Ahlgren technique. (a) Augmentation by nearby fascia. (b) Interosseous suture
Figure 7
Figure 7
Augmentation by peroneal brevis flap. (a) Watson-Jones. (b) Evans. (c) Chrisman-Snook. (d) Colville

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Source: PubMed

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