• Title/Summary/Keyword: 외측 불안정증

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Anatomical Reconstruction of the Lateral Ankle Ligaments using Semitendinosus (반건양근 건을 이용한 족관절 외측 인대의 해부학적 재건)

  • Lee, Woo-Chun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.19-23
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    • 2008
  • Purpose: Several methods of anatomical reconstruction for chronic lateral ankle instability has been reported to avoid the problems of nonanatomical reconstruction. Precise reconstruction of the normal anatomy is essential to the restoration of normal joint mechanics and stability. The problem with anatomical reconstruction is that it is very difficult to reconstruct the normal anatomic course of the ligaments. We thought making one tunnel at the fibular attachment of anterior talofibular ligament and calcaneofibular ligament was more anatomical than making separate tunnels for each ligaments because the two ligaments are contiguous. In this article, the basis of anatomical reconstruction of the lateral ankle ligaments was reviewed and a technique of reconstruction using semitendinosus was introduced.

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Chronic Lateral Ankle Instability (만성 족관절 외측 불안정증)

  • Jung, Hong-Geun;Park, Jae-Yong;Park, Jong-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.73-78
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    • 2012
  • Severe ankle sprain secondarily leads to chronic lateral ankle instability in 20-30%. Many surgical procedures have been presented for reconstruction of the lateral ankle instability, but controversy still remains for the ideal surgical option. Br$\ddot{o}$strom procedure or its modifications have been widely used but they have some limitations for the instabilities for the over-weight, physically high demanding patients and especially for significantly deficient or attenuated ligaments. Moreover the tenodesis procedures using peroneus brevis tendon are non-anatomical and sacrifice important lateral stabilizing tendon. Therefore recently, many reconstructive procedures for lateral ankle instability utilizing free allograft or autograft tendon have been introduced to anatomically stabilize the lateral ligaments to various degrees.

Surgical Outcomes of Arthroscopic Modified Brostr$\ddot{o}$m Procedure in Chronic Lateral Ankle Instability (족관절 만성 외측 불안정증에서 관절경하 변형 Brostr$\ddot{o}$m 술식의 수술적 결과)

  • Cha, Min Seok;Cha, Seung Do;Kim, Eung-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.283-287
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    • 2013
  • Purpose: To evaluate the result of arthroscopic modified Brostrom procedure with suture anchor for chronic lateral ankle instability. Materials and Methods: Fifty-two patients with chronic lateral ankle instability were analyzed, who underwent arthroscopic modified Brostrom procedure between December 2010 and May 2012. Clinical evaluation was performed using AOFAS scroring and Sefton grading system. Results: The average AOFAS hind foot score increased from preoperative 61.9 to 88.8 at the last follow up. There were 35 excellent, 9 good, 4 fair, 4 poor results according to Sefton grading system. For one patient, lateral ankle instability recurred. Conclusion: Arthroscopic modified Brostrom procedure is considered to be an effective and satisfactory technique.

Broström Procedure and Fibula Periosteal Turn Down Augmentation for the Ball-and-Socket Ankle Accompanying Lateral Ankle Instability: A Case Report (Broström 술식과 비골 골막 젖힘 보강술로 치료한 구상 발목관절에 동반된 족근관절 외측 불안정증: 증례 보고)

  • Shin, Woojin;Cho, Hong Man;Park, Jiyeon
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.98-101
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    • 2020
  • We report on the case of a patient with chronic instability of the ball-and-socket ankle joint. The patient, a 21-year-old male, was diagnosed 10 years previously with chronic instability of the ball-and-socket ankle joint. He underwent Broström procedure and augmentation using a periosteal turn down from the fibula for this chronic instability despite having received conservative treatment since the diagnosis. After the procedure, the clinical symptoms of ankle instability were improved and the patient is being periodically followed-up. We report on this case of using a Broström procedure as a treatment option for patients with instability of the ball-and-socket ankle joint with normal range of foot and normal ankle joint alignment without damage in the joint and cartilage.

Treatment for Chronic Lateral Instability of the Ankle with Modified Brostrom Procedure(6 cases) (Modified Brostrom 술식을 이용한 만성 족근관절 외측 불안정증의 치료)

  • Park, Yong-Wook;Chung, Yung-Khee;Yoo, Jung-Han;Lee, Kang-Il
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.1
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    • pp.6-12
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    • 1998
  • Many surgical procedures have been described for the treatment of chronic lateral instability of the ankle. Tenodesis procedures using peroneus brevis tendon is traditionally common among them. Recently, the modified Brostrom anatomic procedure, that is, tightening the stretched out lateral ligaments to restore their norma] anatomy without the use of supplemental tissues and then suturing the lateral portion of the extensor retinaculum to the distal fibula over the ligament repair. has been gaining in popularity. We have reviewed 6 of 10 consecutive cases at an average of 17 months after modified Brostrom procedure. An excellent or good result was achieved in 5 cases, all of which had improved mechanical stability as measured radiographically. One case that had an unsatisfactory result was in patient who had had a previous Evans' operation. So, we believed that the modified Brostrom procedure is an excellent treating method for chronic lateral instability of the ankle.

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Surgical Procedures for Chronic Lateral Ankle Instability (만성 외측 발목 불안정증의 수술적 치료)

  • Young, Ki Won;Lee, Hong Seop;Hwang, Ji Sun
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.17-24
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    • 2021
  • Surgical treatments for chronic lateral ankle instability include anatomic repair, anatomic reconstruction using an auto or allograft, non-anatomic reconstruction, and arthroscopic repair. Open anatomic repair using the native ligament with or without reinforcement of the inferior extensor retinaculum is commonly performed in patients with sufficient ligament quality. Non-anatomical reconstruction using the adjacent peroneus brevis tendon is typically used only in patients with poor-quality ligament remnants or when previous repair failed. Anatomical reconstruction can be considered in patients in whom anatomical repair is expected to fail and when performed using auto or allografts can provide good to excellent short-term results, although the long-term outcomes of these methods remain unclear. Arthroscopic repair can provide good to excellent short-term clinical outcomes, but evidence supporting this technique is limited. The advantages and disadvantages of various surgical methods should be compared, and appropriate treatment should be implemented based on patient characteristics.

The Indication of Ankle Lateral Ligament Reconstruction Using Tendon Graft in Chronic Ankle Instability (만성 족관절 불안정증에서 건이식을 이용한 외측 인대 재건술의 적응증)

  • Park, Jae Yong;Choi, Gi-Won;Cho, Jae-ho;Kang, Chan;Choi, Kyungjin;Chung, Jin-Wha;Kim, Hak Jun;Bae, Su-Young;Cha, Seung-Do;Kim, Ki Chun;Han, Seung Hwan;The Insurance Committee of Korean Foot and Ankle Society
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.1
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    • pp.12-18
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    • 2016
  • Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.