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Orthop Traumatol Surg Res. 2017 Feb;103(1S):S171-S181. doi: 10.1016/j.otsr.2016.06.026. Epub 2016 Nov 18.

Lateral ligament reconstruction procedures for the ankle.

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Centre ostéo-articulaire des Cèdres, 5, rue des Tropiques, Parc Galaxie-Sud, 38130 Échirolles, France. Electronic address:
Service de chirurgie orthopédique et traumatologique, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France; Laboratoire d'anatomie, faculté de médecine, 2, rue Dr-Marcland, 87025 Limoges, France.


Capsule/ligament lesions of the lateral compartment of the ankle lead to lateral laxity, which is a prime contributor to chronic ankle instability. Lateral ligament reconstruction stabilizes the joint. Exhaustive preoperative clinical and paraclinical work-up is essential. The present article classifies, presents and criticizes the main techniques in terms of long-term stabilization and reduction of osteoarthritis risk. Anatomic ligament repair with reinforcement (mainly extensor retinaculum) or anatomic ligament reconstruction are the two recommended options. Non-anatomic reconstructions using the peroneus brevis should be abandoned. Arthroscopy is increasingly being developed, but results need assessment on longer follow-up than presently available. Postoperative neuromuscular reprogramming is fundamental to optimal recovery. Finally, the concept of complex ankle instability is discussed from the diagnostic and therapeutic points of view. The various forms of ligament reconstruction failure and corresponding treatments are reported.


Ankle; Instability; Lateral ligament reconstruction

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