[Primary plastic reconstruction of a lateral ligament injury of the upper ankle joint]

The article introduces a new aspect in the treatment of ruptures of the lateral ligaments of the ankle. We used the modification of tenodesis according to Castaing and Meunier (3) in the operation of the acute lesions of the fibular ligament. The wearing of a cast for 6-7 weeks after operation is generally not necessary because stability of ankle joint ligaments is obtained. The disadvantages of complete immobilization and trophic changes as well as tenodesis effect are avoided. The patients begin with functional physiotherapy after wound healing (10th postoperative day). Careful extremity loading of the selected, active patient is possible four weeks after operation. 118 reconstructions of the ankle joint ligaments (96 with the abovementioned method) have been performed in the Department of Surgery of Witten-Herdecke University between 1970-1982. Of 43 patients checked in follow-up examination (mean postoperative period three years) 5 showed unsatisfactory balance (tenodesis effect).