Functional instability of the foot (a term used in this paper to designate the disability to which patients refer when they say that their foot tends to " give way ") follows about 40 per cent of injuries to the lateral ligament of the ankle (Bosien, Staples and Russell 1955 ; Freeman THE JOURNAL OF BONE AND JOINT SURGERY THE ETIOLOGY AND PREVENTION OF FUNCTIONAL INSTABILITY OF THE FOOT 679 MATERIAL (Tables I and II) Eighty-five patients presenting consecutively at the Casualty Department of Westminster Hospital with recent sprains of the foot and ankle were studied. Every patient was examined radiographically to exclude bone injury. ETIOLOGY AND PREVENTION OF FUNCTIONAL INSTABILITY OF THE FOOT ThE JOURNAL OF BONE AND JOINT SURGERY THE ETIOLOGY AND PREVENTION OF FUNCTIONAL INSTABILITY OF THE FOOT We wish to express our gratitude to Mr D. L. Evans for permission to study his patients and to Dr D. A. Brewerton and the staff of the Physiotherapy Department of Westminster Hospital for treating the patients on our behalf.
1. Forty-two previously asymptomatic patients presenting with a recent rupture of the lateral ligament of the ankle, and twenty similar patients with a simple sprain of this ligament, have been followed for one year. The physical and radiological findings upon the completion of treatment have been related to functional instability of the foot one year later. 2. Persistent mechanical varus instability of the talus in the ankle mortise was a possible cause of functional instability one year after injury in four (or perhaps six) patients. 3. Adhesion formation was a possible cause of functional instability in one patient. 4. Seventeen patients finally displayed no clinical or radiological abnormality after injury, but noted functional instability of the foot one year later. 5. It is concluded that the pathological process which is usually responsible for functional instability of the foot after a lateral ligament injury is at present unknown.
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