Historical Perspectives on Injuries of the Ligaments of the Ankle

Balduini, Frederick C.; Tetzlaff, John E.

doi:10.1016/s0278-5919(20)31504-0

Cited by 111 publications

(21 citation statements)

References 23 publications

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“…Older texts described a purely anatomical classification, whereas more recent papers have described a more functional system. 30 , 50 , 87 , 88 Grade I injuries involve stretched ligaments without macroscopic tearing, little swelling or tenderness, minimal or no functional loss, and no mechanical instability of the joint. A grade II injury is a partial macroscopic tear in the ligament with moderate pain, swelling, and tenderness over the involved structures.…”

Section: How Should Injuries Of the Lateral Complex Be Classified?mentioning

confidence: 99%

“…Stable injuries (grade I) of the lateral complex recover quickly with non-surgical management and have an excellent prognosis. 4 , 28 – 30 , 40 , 87 , 88 , 92 Here we will focus on the treatment of unstable injuries (grades II and III). Three treatment options are available: surgery, immobilization, and functional treatment.…”

Section: Should Injuries To the Lateral Ligament Complex Be Treated Bmentioning

confidence: 99%

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Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

Polzer

Kanz²,

Prall³

et al. 2012

Orthop Rev

120

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Acute ankle injuries are among the most common injuries in emergency departments. However, there are still no standardized examination procedures or evidence-based treatment. Therefore, the aim of this study was to systematically search the current literature, classify the evidence, and develop an algorithm for the diagnosis and treatment of acute ankle injuries. We systematically searched PubMed and the Cochrane Database for randomized controlled trials, meta-analyses, systematic reviews or, if applicable, observational studies and classified them according to their level of evidence. According to the currently available literature, the following recommendations have been formulated: i) the Ottawa Ankle/Foot Rule should be applied in order to rule out fractures; ii) physical examination is sufficient for diagnosing injuries to the lateral ligament complex; iii) classification into stable and unstable injuries is applicable and of clinical importance; iv) the squeeze-, crossed leg- and external rotation test are indicative for injuries of the syndesmosis; v) magnetic resonance imaging is recommended to verify injuries of the syndesmosis; vi) stable ankle sprains have a good prognosis while for unstable ankle sprains, conservative treatment is at least as effective as operative treatment without the related possible complications; vii) early functional treatment leads to the fastest recovery and the least rate of reinjury; viii) supervised rehabilitation reduces residual symptoms and re-injuries. Taken these recommendations into account, we present an applicable and evidence-based, step by step, decision pathway for the diagnosis and treatment of acute ankle injuries, which can be implemented in any emergency department or doctor's practice. It provides quality assurance for the patient and promotes confidence in the attending physician.

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Section: How Should Injuries Of the Lateral Complex Be Classified?mentioning

confidence: 99%

Section: Should Injuries To the Lateral Ligament Complex Be Treated Bmentioning

confidence: 99%

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

Polzer

Kanz²,

Prall³

et al. 2012

Orthop Rev

120

View full text Add to dashboard Cite

show abstract

“…The most common mechanism of injury to the ankle ligaments is inversion of the foot [ 4 , 33 ]. With this mechanism of injury, the anterior talofibular ligament is the first or only ligament to sustain injury [ 43 ].…”

Section: Introductionmentioning

confidence: 99%

Anatomy of the ankle ligaments: a pictorial essay

Golanó

Vega

Leeuw

et al. 2010

Knee Surg Sports Traumatol Arthrosc

352

345

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Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail.

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“… 12 , 22 Most injuries involve the lateral ligament complex (LLC) during forced inversion and adduction while the ankle joint is in plantarflexion. 3 , 14 Tearing, stretching, and recurring sprains of these ligaments can result in chronic ankle instability (CAI). It has been reported that 32% to 74% of individuals with a history of ankle sprain experience some type of residual and chronic symptoms, recurrent ankle sprains, and/or perceived instability.…”

mentioning

confidence: 99%

Sonographically Guided Anchor Placement in Anterior Talofibular Ligament Repair Is Anatomic and Accurate

Hattori

Onishi

Yano

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Arthroscopic repair is a widely accepted surgical treatment for chronic ankle instability; however, recent studies have shown that arthroscopic repair is nonanatomic in its anchor placement and resultant biomechanics. Ultrasound may improve the accuracy of the anchor placement. Hypothesis: Our hypothesis was that the accuracy of anchor placement in sonographically guided anterior talofibular ligament (ATFL) repair will be comparable with that in open ATFL repair. Study Design: Cohort study; Level of evidence, 3. Methods: The study included 26 patients who received surgical treatment between April 2012 and October 2019 for chronic ankle instability. Fifteen patients underwent open modified Broström repair and 11 underwent sonographically guided ATFL repair. The distance between the anchor hole and the fibular obscure tubercle was measured using 3-dimensional computed tomography and was compared between the operative procedures. For comparison, a noninferiority trial was employed, with open modified Broström repair as the reference surgery. The noninferiority margin was defined as 5 mm. Results: The mean ± SD distance between the anchor and fibular obscure tubercle was 6.0 ± 2.7 mm in open repair and 5.6 ± 3.3 mm in sonographically guided repair. The mean difference in distance between the techniques ( open repair – sonographically guided repair) was 0.37 mm (95% CI, –2.1 to 2.9 mm). The lower margin of the confidence interval was within the noninferiority margin (–5 to 5 mm). Conclusion: Anchor placement under sonographically guided ATFL repair was equivalent to that of open ATFL repair and can be considered anatomic and accurate.

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Historical Perspectives on Injuries of the Ligaments of the Ankle

Cited by 111 publications

References 23 publications

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

Anatomy of the ankle ligaments: a pictorial essay

Sonographically Guided Anchor Placement in Anterior Talofibular Ligament Repair Is Anatomic and Accurate

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