Reconstruction of the lateral ligaments of the ankle for chronic lateral instability

One hundred and seventy-six patients (180 ankles) who had chronic lateral instability of the ankle were treated with transection and imbrication of the anterior talofibular ligament. Sixty-eight of the ankles had reconstruction of the calcaneofibular ligament as well. Of the 176 patients, 148 (152 ankles) were available for follow-up, which ranged from two to twelve years (mean, six years). An excellent or good result was achieved in 132 ankles, all of which had improved mechanical stability as measured radiographically. Sixteen of the twenty ankles that had an unsatisfactory result were in patients who had generalized hypermobility of the joints or long-standing local ligamentous insufficiency, or both, or who had had a previous operation. Reconstruction of both ligaments gave a better functional result than when only the anterior talofibular ligament was reconstructed.