Chronic, recurring ligament instability in the lateral ankle

Area of Science:

• Orthopedics
• Sports Medicine
• Biomechanics

Background:

• Chronic ankle instability affects 10-20% of individuals after acute lateral ankle ligament rupture.
• It results from ligamentous damage and neuromuscular dysfunction of the peroneal muscles.

Purpose of the Study:

• To review the diagnostic methods and management strategies for chronic ankle instability.
• To outline the indications and surgical options for ligament reconstruction.

Main Methods:

• Standard diagnostic approaches include patient history, clinical examination, and radiological stress tests.
• Advanced diagnostics involve stabilometry, Cybex measurements, peroneal reaction time evaluation, and dynamic pedography.
• Conservative management includes ankle bracing and peroneal muscle rehabilitation programs.

Main Results:

• Surgical reconstruction is indicated for documented mechanical instability with intact neuromuscular reflexes and failed conservative treatment.
• Surgical procedures follow a priority list: anatomical repair, Watson-Jones tenodesis, and Chrisman-Snook tenodesis for subtalar instability.

Conclusions:

• Effective management of chronic ankle instability requires accurate diagnosis and tailored treatment, ranging from conservative measures to surgical intervention.
• Surgical technique selection depends on the degree of instability and associated subtalar joint involvement.