Lateral Ankle Instability after Rotational Injury: A Case Report

One of the most common orthopedic injury injuries seen in patients at the emergency department is that of the ankle. There are some efficient protocols for their treatment, but more often the clinician is fo-cused in finding and treating possible fractures and disregards ligamentous lesions that lead to instabil-ity, if they become chronic.

A patient that suffered an ankle sprain was improperly handled, developed lateral instability of the ankle, and was treated surgically using an autologous semitendinosus graft. A 42-year year-old Caucasian male that after an ankle sprain was examined in various primary health -care centers, four times within six 6 months, with persistent symptoms of his left ankle. After all these months, he was eventually diagnosed with post-traumatic lateral instability of the ankle that was resistant to con-servative treatment. In stress view X-rays, the talar tilt angle was 21°ο and the anterior drawer was measured at 13 mm. The patient was treated surgically with reconstruction of the anterior talofibular and the calcaneofibular ligament using an autologous semitendinosus graft from the left knee. The graft was pinned in the anatomical insertion sites of the ligaments with absorbable screws. A post-surgical physiotherapy regimen was applied for two 2 months. In the post-surgical dynamic stress view X-rays, the talar tilt angle and the anterior drawer were markedly improved, measured at 3°ο and 4 mm, respec-tively. In 11 months post-surgical follow-up, the patient's American Foot and Ankle Score was 85, from the 60 evaluated before treatment.

The use of guidelines, regular follow-ups, and functional rehabilitation are key factors to treating ankle injuries. The reconstruction of lateral collateral ligament complex with a semitendinosus graft is one of the surgical options for restoring lateral ankle instability.