Acta Ortopédica Mexicana

Romero-Cruz, JA Ramírez-Salgado CU, de la Cruz-Honorato E, Acosta RR
Comparative study between surgical treatment vs conservative in the chronical instability of the ankle
Acta Ortop Mex 2003; 17 (5)

Language: Español
References: 22
Page: 237-242
PDF: 105.46 Kb.

[Fulltext - PDF]

ABSTRACT

Ligament injuries of the ankles are one of the most frequent injuries in general medical practice and emergencies rooms, the being most frequently affected the lateral ligaments with forced inversion as the most frequent mechanisms of injuries. A clinical trial was preformed in 39 voluntary patients with diagnosis of chronic mechanical instability of the ankle, 20 of them were treated with ligamentary reconstruction with the Chrisman-Snook technique, and the rest 19 with rehabilitation exercises. All patients were evaluated with the AOFAS scale before treated, and also 6 and 18 months later with the same. Scale after the treatment, we use the score of the score of the scale in each patient to assess the clinical improument. We can conclude with this trial that ligament repairment with the Chrisman-Snook technique is more effective than the management conservative with rehabilitation exercises in the chronical instability of the ankle.


Key words: Ankle injuries, lateral ligaments, therapy, rehabilitation.


REFERENCES

  1. Becker HP, Rosenbaum D: Chronic recurrent ligament instability on the lateral ankle. Orthopade 1999; 28(6): 483-492.

  2. Braun BL: Effects of ankle sprain in a general clinic population 6 to 18 months after medical evaluation. Arch Fam Med 1999; 8: 143-148.

  3. Brunner R, Gaechter A: Repair of fibular ligament: comparison of reconstructive techniques using plantaris and peroneal tendons. Food & Ankle 1991; 11(6): 359-367.

  4. Campbell’s: Campbell’s operative orthopaedics. Mosby, Inc. Ninth edition. 1998: 1080-1096.

  5. Colville MR: Surgical treatment of the unstable ankle. J Am Acad Orthop Surg 1998; 6: 368-377.

  6. Eisele SA: The orthopedic clinics of North America. W.B. Saunders Company. 1994; 25(1): 1-14, 29-30, 61-62.

  7. Ferkel RD: Arthroscopic surgery. The Foot and Ankle. Lippincott-Raven Publishers. 1996: 7-9, 201-204.

  8. Freeman MA: Instability of the foot after injuries to the lateral ligament of the ankle. J Bone and Joint Surgery 1965; 47(4): 669-677.

  9. Fujii T, Luo Z, Kitaoka H, An K: The manual stress test may not be sufficient to differentiate ankle ligament injuries. Clin Biomech 2000; 15(8): 619-623.

  10. Hennrikus WL, Mapes R, Lyons P, Lapoint JM: Outcomes of the Chrisman-Snook and modified-Brostrom procedures for chronic lateral ankle instability. Am J Sports Med 1996; 24(4): 400-404.

  11. Hintermann B: Biomechanics of the unstable ankle joint and clinical implications. Med Sci Sports Exerc 1999; 31(7): 459-69.

  12. Hoppenfeld S: Exploración física de la columna vertebral y las extremidades. Manual Moderno. 1997; 17va. Impresión: 352-401.

  13. Karlsson J, Bergsten T, Lansinger O, Peterson L: Reconstruction of the lateral ligaments of the ankle for chronic lateral instability. J Bone Joint Surg Am 1988; 70(4): 581-588.

  14. Karlsson J, Eriksson B, Bergsten T, Rudholm O, Sward L: Comparison of two anatomic reconstruction for chronic lateral instability of the ankle joint. Am J Sport Med 1997; 25(1): 48-53.

  15. Karlsson J, Lasinger O: Chronic lateral instability of the ankle in athletes. Sports Med 1993; 16(5): 355-65.

  16. Kitaoka HB, Alexander J, Adelaar RS, Nunley JA, Myerson MS, Sanders M: Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle 1991; 15(7): 349-353.

  17. Malcom G, Andrew J, Angus M: Instability of the ankle after injuries to the lateral ligaments. J Bone Joint Surg 1980; 62-B(2): 196-200.

  18. Moore KL: Anatomía con orientación clínica. Panamericana. 1993; 3a Edición: 510-512.

  19. Pieron AP: Lateral ankle instability correction by translocation of the intact peroneus brevis tendon: a prospective study of 45 cases. J South Orthop Assoc 1998; 7(3): 187-91.

  20. Rockwood G: Rockwood & Green’s Fractures in Adults. Lippincott-Raven publishers. 1996: 2252-2258.

  21. Snook GA, Chrisman OD, Wilson TC: Long-Term Results of the Chrisman-Snook operation for reconstruction of the lateral ligament of the ankle. J Bone Joint Surg 1985; 67(1): 1-7.

  22. Wulker N, Rudert M: Lateral ankle ligament rupture. When is surgical management indicated and when conservative therapy preferred? Orthopaed 1999; 28(6): 476-82.