Comparison of Lateral Ankle Ligamentous Reconstruction Procedures

Abstract

The static restraints of various surgical procedures for chronic lateral ankle instability were compared. Forty cadaveric ankles were divided equally into the follow ing five groups: 1) ankles with intact anterior talo fibular and calcaneofibular ligaments, 2) ankles with incised anterior talofibular and calcaneofibular liga ments, 3) ankles with Chrisman-Snook procedure, 4) ankles with Watson-Jones procedure, or 5) ankles with modified Broström procedure. All ankles were placed in a mechanical apparatus for anterior drawer stress and inversion stress tests. After each applica tion of force, a radiograph of the ankle joint was taken, and the anterior talar displacement and the ta lar tilt angle were measured.

All procedures reduced anterior drawer and talar tilt when compared with the ankles with incised anterior talofibular and calcaneofibular ligaments. Significant differences were found among the groups for both in version and anterior drawer stress at all forces, except for the third and fourth groups. The modified Broström group had the least amount of anterior talar displace ment and talar tilt angle at all forces. There were no significant differences between the Watson-Jones and the Chrisman-Snook procedures in anterior talar dis placement and talar tilt. The modified Broström proce dure produced a greater mechanical restraint than either of the other procedures.