Radiographic Evaluation of Ankle Joint Stability

Karlsson, Jón; Bergsten, Tommy; Peterson, Lars E.; Zachrisson, B. F.

doi:10.1097/00042752-199107000-00004

Cited by 43 publications

(32 citation statements)

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“…Apart from differences in experimental setup which could, in part, explain the different conclusions reached, the fact remains that individual variations in ligament orientation (Burks and Morgan 1994) may cause different laxity patterns in different patients. In both the present and other mechanical studies, as well as clinical studies (Karlsson et al 1991), the motion changes vary greatly, depending on the individual specimen or patient. Thus, it may be that testing should be done at several flexion angles, since it is not possible to give universal recommendations as to the best flexion angles for testing.…”

Section: Discussionmentioning

confidence: 80%

Mechanics of the anterior drawer and talar tilt tests: A cadaveric study of lateral ligament injuries of the ankle

Bahr¹,

Peña²,

Shine³

et al. 1997

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 80%

Mechanics of the anterior drawer and talar tilt tests: A cadaveric study of lateral ligament injuries of the ankle

Bahr¹,

Peña²,

Shine³

et al. 1997

Acta Orthopaedica Scandinavica

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“…Anatomic reconstruction which includes imbrication and reinsertion of both the anterior talo-fibular and calcaneo-fibular ligaments has become increasingly popular (28,29). Gould et al (30) reported on an anatomic reconstruction of the lateral ligaments in combination with the inferior extensor retinaculum in patients with combined lateral instability of the ankle and subtalar instability.…”

mentioning

confidence: 99%

Subtalar instability of the foot: A review and results after surgical treatment

Karlsson¹,

Eriksson²,

Renström

1998

Scandinavian Med Sci Sports

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instability of the foot. A review and results after surgical treatment.Scand J Med Sci Sports 1998: 8: 191-197. 0 Munksgaard, 1998 Most subtalar ligamentous injuries occur in combination with ankle ligament injuries, but the exact aetiology and the true incidence remain unknown. The aim of this study was to review the problem, propose a definition and to analyze the results of an anatomic reconstructive surgical technique in the treatment of subtalar instability. Twenty-two patients suffering from chronic subtalar instability of the foot were operated with anatomical reconstruction. The cervical, the lateral talo-calcaneal and the calcaneo-fibular ligaments were imbricated and reinforced with the lateral root of the inferior extensor retinaculum. After a minimum of 2 years follow-up the functional results were excellent or good in 18 of 22 (82%) patients and fair or poor in 4 of 22 (18%). All of the patients with unsatisfactory results suffered from residual ankle pain, two of whom also had residual instability. No reoperations have been performed. Surgical complications were seen in three patients, all minor nerve injuries of the lateral branch of the superficial peroneal nerve. These complications had no bearing on the functional results, however. This procedure was found to be feasible in patients with chronic subtalar instability.

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“…Stress radiographs were not taken due to the inconsistency of results obtained without the aid of a stresstesting machine. 18 Clinical stability of the ankle is dependent not only on mechanical stability, but also on proprioception. 2 We relied on clinical examination and found a strong correlation between ankles which were clinically lax and symptoms of instability.…”

Section: Discussionmentioning

confidence: 99%

A long-term review of a modified Evans procedure

Nimon

Dobson

Angel

et al. 2001

The Journal of Bone and Joint Surgery. British volume

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O f 111 primary ankle ligament arthroplasties (modified Evans procedure) performed between 1983 and 1994, we were able to identify 89 patients (94 ankles) for follow-up. All were under 50 years of age. Two had died and one refused to co-operate; 86 patients (91 ankles) were therefore reviewed, 25 by telephone and the remainder by clinical examination with all but three also undergoing radiological review.Of the 91 ankles, 70 had no or very mild pain and 72 had no or rare episodes of instability and when considered together only 59 (65%) had no or mild pain and minimal instability. Injuries of the lateral ligament complex of the ankle are common.1 Opinions on the treatment of an acute disruption of the lateral ligament complex have varied between early repair and non-operative management. The latter is the mainstay of treatment with emphasis on early mobilisation rather than immobilisation in a cast. 1-3A large number of methods of reconstruction have been described, many being slight variations of the same technique. The techniques are either non-anatomical with a tendon graft or fascia lata, 4-8 or anatomical in which the remnants of the ligaments are either repaired or sutured to bone, with or without augmentation with another structure such as the inferior extensor retinaculum. 9Anatomical reconstructions have been shown to reduce talar tilt and the anterior-drawer sign to a greater extent than occurs with non-anatomical reconstructions.7-9 While the short-term results are good, the long-term results are unknown.The short-and long-term results for various non-anatomical reconstructions have, however, been well documented and vary considerably. [10][11][12][13] The Evans procedure is a nonanatomical reconstruction which was first described in 1953 4 as a dynamic stabilisation of the ankle. The tendon of peroneus brevis is divided below the musculotendinous junction and passed through a tunnel drilled in the fibula, starting distally at the tip of the fibula and emerging posteriorly and superiorly. The tendon is then re-attached to its muscle belly. Since the initial description the procedure has been modified by two main variations. One involves routing the tendon of peroneus brevis posterosuperiorly through the tunnel so that it emerges at the tip of the fibula, and then attaching it alongside its insertion at the base of the fifth metatarsal. 11,12 The second variation follows the original procedure, but all or part of the tendon is taken through the tunnel and sutured to the fibular periosteum, thus allowing it to act as a tenodesis rather than a dynamic stabiliser. The senior authors (PJD, KRA, PLL, TMS) have used the second modification of the Evans procedure since 1983. We have studied retrospectively all such patients to determine long-term satisfaction, stability, hindfoot biomechanics and the rate of degenerative changes.

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Radiographic Evaluation of Ankle Joint Stability

Cited by 43 publications

References 0 publications

Mechanics of the anterior drawer and talar tilt tests: A cadaveric study of lateral ligament injuries of the ankle

Mechanics of the anterior drawer and talar tilt tests: A cadaveric study of lateral ligament injuries of the ankle

Subtalar instability of the foot: A review and results after surgical treatment

A long-term review of a modified Evans procedure

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