Treatment of lateral ankle instability with transfer of the extensor digitorum brevis muscle

Westlin, Nils E.; Vogler, Harold W.; Albertsson, Magnus P.; Arvidsson, Tina; Montgomery, Fredrik

doi:10.1016/s1067-2516(03)70027-1

Cited by 18 publications

(11 citation statements)

References 109 publications

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“…In our study the median KAFS was 88 points with 65% reaching a good or excellent outcome. In the literature on non-anatomical reconstructions, median KAFS scores between 67 and 95 points have been published [28, 30, 49, 54]. Good to excellent outcome varies from 33 to 100% in recent studies with peroneus brevis ligamentoplasty and a minimum of five years follow-up [27, 28, 30, 34, 39].…”

Section: Discussionmentioning

confidence: 99%

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Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

Schepers

Vogels

Lieshout

2011

International Orthopaedics (SICOT)

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PurposeIn the treatment of chronic ankle instability, most non-anatomical reconstructions use the peroneus brevis tendon. This, however, sacrifices the natural ankle stabilising properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of patients treated with a hemi-Castaing procedure, which uses only half the peroneus brevis tendon.MethodsWe performed a retrospective cohort study of patients who underwent hemi-Castaing ligamentoplasty for chronic lateral ankle instability between 1993 and 2010, with a minimum of one year follow-up. Patients were sent a postal questionnaire comprising five validated outcome measures: Olerud-Molander Ankle Score (OMAS), Karlsson Ankle Functional Score (KAFS), Tegner Activity Level Score (pre-injury, prior to surgery, at follow-up), visual analog scale on pain (VAS) and the Short Form 36 (SF-36).ResultsTwenty patients completed the questionnaire on functional outcome. The OMAS showed good to excellent outcome in 80% and the KAFS in 65%, the Tegner Score improved from surgery but did not reach pre-injury levels, the VAS on pain was 1 of 10 and the SF-36 returned to normal compared with the average population.ConclusionsEven though most patients were satisfied with the results, outcome at long-term follow-up was less favourable compared with the literature on anatomical reconstructions. In accordance with the literature, we therefore conclude that the initial surgical treatment of chronic lateral ankle instability should be an anatomical repair with augmentation (i.e. the Broström-Gould technique) and the non-anatomical repair should be reserved for unsuccessful cases after anatomical repair or in cases where no adequate ligament remnants are available for reconstruction.

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Section: Discussionmentioning

confidence: 99%

“…Good to excellent outcome varies from 33 to 100% in recent studies with peroneus brevis ligamentoplasty and a minimum of five years follow-up [27, 28, 30, 34, 39]. It is noteworthy that the highest outcome scores are obtained in the smallest groups [49, 54]. …”

Section: Discussionmentioning

confidence: 99%

Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

Schepers

Vogels

Lieshout

2011

International Orthopaedics (SICOT)

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“…Westin, et al, 9 described their results using a procedure of treating lateral ankle instability with extensor digitorum brevis muscle. In this procedure, the proximal attachment of the extensor digitorum brevis is transferred to the anterior border of the lateral malleolus.…”

Section: Discussionmentioning

confidence: 99%

Technique for Single-Graft Lateral Ankle Stabilization: A Cadaveric Biomechanical Study

Clifford¹,

McCann²

2011

FAOJ

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The Foot and Ankle Online Journal 4 (7): 3 Several surgical procedures have been described for treatment of lateral ankle instability with varying degrees of success and complications. The purpose of this study was to describe a modification to the 2295). There was no significant difference between anterior displacement index of specimens with ligaments intact and ligaments grafted (p= .6482). A cadaveric model is used to demonstrate that lateral ankle ligaments can be repaired using a new single-graft technique, and is comparable to presectioned intact lateral ankle ligaments.Key words: Ankle Instability, Tendon Graft, Biotenodesis Anchors, Talar Tilt, Anterior Displacement. ateral ankle instability is a chronic, debilitating condition that commonly develops from an acute injury. Chronic instability has been described as a progressive process that results from the anatomic changes following an acute injury. These initial anatomic changes predispose the joint to further injury, and eventual chronic instability. The Bröstrom procedure was described for primary repair of ruptured lateral ligaments. 2 Modifications have been made to this procedure to reinforce the construct, including incorporation of the capsular structures into the repair for added strength. The modified Bröstrom procedure remains the goldstandard to which most reconstructive procedures are compared, and has been found to provide good to excellent results in 91% of patients at 26-year followup. 4 Despite the favorable outcomes of the Bröstrom procedure, it is not always possible due to overattenuation of lateral soft tissues, or poor-quality of soft tissues due to previous surgery.

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“…Due to bipedal posture the function of little toe is minimal and has no opposition action in humans. Hence, the tendon of little toe coming from flexor digitorum brevis muscle maybe absent sometime such variations of flexor digitorum is of clinical importance because it is often used in reconstruction of the heel pad and it is frequently used to correct cross over deformity and to treat painful toe disorders such as lateral ankle deformity [3,4]. Recent and ongoing advances in plastic and orthopedic surgeries of lower limb have created a need for detailed understanding of anatomical variations and morphometry of flexor digitorum brevis muscle.…”

Section: Introductionmentioning

confidence: 99%

STUDY OF ABSENCE OF 4Th TENDON OF FLEXOR DIGITORUM BREVIS MUSCLE

Agarwal¹,

Khajuria²,

Saini³

2017

IJAR

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Background: Flexor digitorum brevis is an intrinsic muscle of the sole of foot that lies immediately deep to central part of plantar aponeurosis.The flexor digitorum brevis divided into four tendons for lateral four toes. Each tendon is divided into two slips at base of proximal phalanx, to allow the flexor digitorum longus tendons and get inserted on both sides of the shaft of middle phalanx. It helps to reinforce arch of foot by flexing the proximal interphalangeal and metatarsophalangeal joints of the lateral four toes. Flexor digitorum brevis muscular flap is used in the reconstruction of the heel pad and it is frequently used to correct crossover toe deformity so architecture of the foot is important because it may help in the surgical procedures during correction of above deformities.

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Treatment of lateral ankle instability with transfer of the extensor digitorum brevis muscle

Cited by 18 publications

References 109 publications

Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

Technique for Single-Graft Lateral Ankle Stabilization: A Cadaveric Biomechanical Study

STUDY OF ABSENCE OF 4Th TENDON OF FLEXOR DIGITORUM BREVIS MUSCLE

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