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Surgical treatment of lateral ankle instability syndrome

Department of Orthopaedic Surgery, University of Cincinnati Medical Center, and the Foot and Ankle Center, Cincinnati, Ohio

Charles V. Diraimondo, MD

Department of Orthopaedic Surgery, University of Cincinnati Medical Center, and the Foot and Ankle Center, Cincinnati, Ohio

Lateral ankle instability syndrome is defined by pain and instability caused by ligament laxity. Anterior talo fibular ligament laxity, with or without calcaneofibular laxity and other abnormalities, is often present in con junction with peroneus brevis tendon tears, abnormal ligament placement, tibialis posterior tendon tears, os teochondritis dissecans, arthritis, synovitis, loose bod ies, and tarsal coalition. Surgical reconstructions were performed on 43 ankles using a split peroneus brevis tendon graft routed through osseous tunnels in the talus, fibula, and calcaneus and resutured to the recon structed anterior talofibular and calcaneofibular liga ments. The tunnel locations, transfer routes, and ten don reinforcement were modifications based on the Elmslie procedure. Good and excellent results were achieved in 91% of the patients. Ninety-eight percent of the patients achieved stability. Followup was from 9 months to 11 years. Twenty-one patients had preop erative and intraoperative findings that required addi tional procedures.

Thorough evaluation of patients with lateral ankle instability syndrome increases the frequency of finding associated abnormalities, which if left uncorrected, may adversely affect the outcome of surgery.

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