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Comparison of Two Anatomic Reconstructions for Chronic Lateral instability of the Ankle Joint

Department of Orthopaedics, Ostra Hospital, Göteborg, Sweden

Bengt I. Eriksson, MD, PhD

Department of Orthopaedics, Ostra Hospital, Göteborg, Sweden

Tommy Bergsten, MD

Diagnostic Radiology, Ostra Hospital, Göteborg, Sweden

Olof Rudholm, MD

Diagnostic Radiology, Ostra Hospital, Göteborg, Sweden

Leif Swärd, MD, PhD

Department of Orthopaedics, Ostra Hospital, Göteborg, Sweden

Two anatomic reconstructions for correction of chronic lateral ankle joint instability were compared. In a pro spective, randomized study, 60 patients were allocated to one of two treatment groups: reconstruction of the ligaments as described by Karlsson et al. (Group I) or with the modification of the Broström procedure as described by Gould et al. (Group II). The functional results were evaluated with a scoring scale, and the mechanical stability with standardized stress radio graphs. The minimum follow-up period was 2 years. The functional results were satisfactory in 27 of 30 (90%) patients in Group I and 25 of 30 (83%) in Group II. There was no significant difference between the groups regarding mechanical stability. The mean an terior talar translation in Group I was 7.1 mm (range, 4 to 10) at followup, compared with 6.7 mm (range, 3 to 9) in Group II. The corresponding values for talar tilt were 4.9° (range, 0° to 8°) in Group I and 4.4° (range, 0° to 8°) in Group II. The duration of operation time was significantly longer in Group II and surgical complica tions were more frequent, probably due to the more extensive surgical exposure. This study showed that the majority of patients with chronic ankle instability can be successfully treated with anatomic reconstruc tion of the lateral ankle ligaments. Mechanical stability was restored with both methods.

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