The palmaris longus tendon was used to reconstruct the anterior talofibular ligament (ATFL) in 27 ankles with chronic lateral instability. The mean age of the patients at surgery was 23 years, and the follow-up was more than 2 years.
The functional evaluation showed excellent or good results in all ankles. Twenty-seven ankles were divided into two groups according to operative findings: group A consisted of 11 ankles with old isolated injury of the ATFL, and group B consisted of 16 ankles with old combined injuries of the ATFL and the calcaneofibular ligament. There were no significant differences in clinical results between group A and group B. The preoperative mean talar tilt angles on stress radiograph in group B were significantly larger than those in group A. At follow-up, there were no significant differences in the mean talar tilt angles between group A and group B.
We demonstrate that reconstruction of the calcaneofibular ligament along with the ATFL is not necessary for patients with chronic combined lateral ligament instability.
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References
1.
. AdachiB.: Beitrage zur Anatomie der Japaner. Die Statisik der Muskelvarietaten. Z. Morphol. Anthropol., 12:261-312, 1910.
2.
. AhlgrenO.LarssonS.: Reconstruction for lateral ligament injuries of the ankle. J. Bone Joint Surg., 71B:300-303, 1985.
3.
. AndersonM.E.: Reconstruction of the lateral ligaments of the ankle using the plantaris tendon. J. Bone Joint Surg., 67A:930-934, 1985.
4.
. BroströmL.: Sprained ankles: VI. Surgical treatment of chronic ligament ruptures. Acta Chir. Scand., 132:551-565, 1966.
5.
. CarlsonG.D., BotteM.J., JosephsM.S., NewtonP.O., DavisJ.L.W.WooS.L.-Y.: Morphologic and biomechanical comparison of tendons used as free grafts. J. Hand Surg., 18:76-82, 1993.
6.
. ChrismanO.D.SnookG.A.: Reconstruction of lateral ligamentous tears of the ankle. J. Bone Joint Surg., 51(7)A:904-912, 1969.
7.
. ColvilleM.R., MarderR.A.ZarinsB.: Reconstruction of the lateral ankle ligaments: a biomechanical analysis. Am. J. Sports Med., 20:549-600, 1992.
. DaselerM.S.AnsornB.J.: The plantaris muscle: an anatomical study of 750 specimens. J. Bone Joint Surg., 25:822-827, 1943.
10.
. EvansD.L.: Recurrent instability of the ankle: a method of surgical treatment. J. R. Soc. Med., 46:343-344, 1953.
11.
. FreemanM.A.R.: Treatment of ruptures of the lateral ligament of the ankle. J. Bone Joint Surg., 47B:661-668, 1965.
12.
. GillespieH.S.BoucherP.: Watson-Jones repair of lateral instability of the ankle. J. Bone Joint Surg., 53(7)A:920–924, 1971.
13.
. GolzR.J., DavisJ.M., HayJ.M.SchmidtT.A.: Reconstruction of the lateral ankle ligaments for chronic instability. Orthop. Trans., 16:341, 1992.
14.
. GoodC.J., JonesM.A.LivingstoneN.: Reconstruction of the lateral ligament of the ankle. Injury, 7:63-65, 1975.
15.
. GouldN., SeligsonD.GrassmanJ.: Early and late repair of lateral ligament of the ankle. Foot Ankle, 1:84-89, 1980.
16.
. HarveyJ., ChuG.HarveyP.M.: Surgical availability of the plantaris tendon. J. Hand Surg., 8:243-247, 1983.
17.
. HoyG.A.HendersonI.J.P.: Results of Watson-Jones ankle reconstruction for instability. J. Bone Joint Surg., 76(7)B: 610-613, 1994.
18.
. JamesB.S.: Inman's Joint of the Ankle, 2nd Ed. Baltimore, Williams & Wilkins, 1991, pp. 58-61.
19.
. KarlssonJ., BergstenT., LansingerO.PetersonL: Lateral instability of the ankle treated by the Evans procedure. J. Bone Joint Surg., 70(3)B:476–480, 1988.
20.
. KarlssonJ., BergstenT., LansingerO.PetersonL.: Reconstruction of the lateral ligaments of the ankle for chronic lateral instability. J. Bone and Joint Surg., 70(4)A:581-588, 1988.
21.
. Kjaersgaard-AndersenP., SojbjergJ.-O., WethelundJ.Q., HelmigP.MadsenF.: Watson-Jones tenodesis for ankle instability: a mechanical analysis in amputation specimens. Acta Orthop. Scand., 60:477-480, 1989.
22.
. Kjaersgaard-AndersenP., WethelundJ.-O.NielsenS.: Lateral talocalcaneal instability following section of the calcaneofibular ligament: a kinesiologic study. Foot Ankle, 7:355-361, 1987.
. LeeH.G.: Surgical repair in recurrent dislocation of the ankle joint. J. Bone Joint Surg., 39(7)A:828–834, 1957.
25.
. NilsonneH.: Making a new ligament in ankle sprain. J. Bone Joint Surg., 14:380-381, 1931.
26.
. OkudaR.: Stress peroneal tenography in the diagnosis of acute and old ruptures of the lateral ligament of the ankle joint. Cent. Japan J. Orthop. Traumatol., 39:10-19, 1996.
27.
. RieglerF.H.: Reconstruction for lateral instability of the ankle. J. Bone Joint Surg., 66(3)A:336–339, 1984.
28.
. RubinG.WittenM.: The talar tilt angle and the fibular collateral ligament: a method for the determination of talar tilt. J. Bone Joint Surg., 42(3)A:311–326, 1960.
29.
. SeligsonD., GrassmanJ.PopeM.: Ankle instability: evaluation of the lateral ligament. Am. J. Sports Med., 8:39-42, 1980.
30.
. SnookG.A., ChrismanO.D.WilsonT.C.: Long-term results of the Chrisman-Snook operation for reconstruction of the lateral ligaments of the ankle. J. Bone Joint Surg., 67(1)A:1-7, 1985.
31.
. StephenH.JacobsonK.E.: A new operation for chronic lateral ankle instability. J. Bone Joint Surg., 77(1)B:55–59,1995.
32.
. St. PierreR.K., AllmanF., BassettF.H., GoldnerJ.L.FlemingL.L.: A review of lateral ankle ligamentous reconstructions. Foot Ankle, 3:114-123, 1982.
33.
. St. PierreR.K., AndrewL., AllmanF.FlemingL.L.: The Cybex II evaluation of lateral ankle ligamentous reconstructions. Am. J. Sports Med., 12:52-56, 1984.
34.
. The Japanese Orthopaedic Association: The method of measuring joint motion. J. Japan. Orthop. Assoc., 69:240-250, 1995.
35.
. Watson-JonesR.: Fractures and Joint Injuries, 4th Ed., Vol. 2. Edinburgh and London: E & S Livingstone, 1955.
36.
. WeberB.G.: Die Verletzungen des Oberen Sprunggelenkes, 2nd Ed. Bern, Verlag Hans Huber, 1972, pp. 192-195.
37.
. YagiR., KanesoK., YoshimotoS., KitadaT.MasuharaK.: Operative treatment for rupture of the collateral ligament of the ankle. Cent. Japan. J. Orthop. Traumatol., 24:1555-1558, 1981.
