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Salvage reconstruction for lateral ankle instability using a tendon allograft
1Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, USA.
Clinical Orthopaedics and Related Research
|November 13, 2003
Summary
Recurrent lateral ankle instability after fibulectomy was treated with a novel tibiotalar allograft reconstruction. This salvage technique successfully restored stability in a patient with a unique fibular absence and tendon deficiency.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Anatomy
Background:
- Lateral ankle instability often follows inversion injuries.
- Surgical intervention may be necessary for recurrent cases unresponsive to conservative treatment.
- Existing literature details numerous lateral ankle stability procedures.
Observation:
- A patient with a distal fibulectomy for osteochondromas underwent lateral ligament reconstruction using peroneus brevis tendon.
- This initial reconstruction failed due to a subsequent severe inversion injury, leading to recurrent instability.
- The absence of the fibula and deficiency of the peroneus brevis tendon presented unique challenges.
Findings:
- A salvage reconstruction of the lateral ligament complex was performed using a tibiotalar bone-tendon allograft.
- The allograft was specifically designed to counteract inversion forces.
- The patient achieved a painless and stable ankle 14 years post-procedure.
Implications:
- This case demonstrates the efficacy of tibiotalar allograft reconstruction for complex lateral ankle instability.
- The technique offers a viable salvage option in cases with fibular absence and tendon compromise.
- This approach may be beneficial for patients with challenging anatomy and previous surgical failures.