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Chronic, Painful Ankle Instability in Skeletally Immature Athletes

Ununited Osteochondral Fractures of the Distal Fibula

Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical Center, Worcester, Massachusetts

Arthur M. Pappas, MD

Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical Center, Worcester, Massachusetts

We report 10 cases of chronic, painful ankle instability in skeletally immature athletes associated with un united osteochondral fragments of the distal fibula. All the patients experienced multiple inversion injuries with recurrent pain and instability that failed to improve after a supervised exercise and rehabilitation program. Osteochondral fragments of the distal fibula were vis ible on all standard radiographs of the affected ankles. Treatment consisted of operative excision of the bony fragment and an anatomic nonaugmented repair of the lateral ligament complex and capsule. All 10 patients were available for long-term followup an average of 6.5 years (±2) after surgery; all ankles improved function ally, with no recurrences of instability.

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