RUDN Journal of Medicine (Dec 2017)
The experience of arthroscopic treatment of chronic anterolateral instability of the ankle jont
Abstract
The article states the concept of chronic lateral instability. There are presented epidemiology, anatomy, ankle, lateral ligaments of the ankle, including the functional significance and anatomical features of each bundle, in details described diagnostics, research methods, including ultrasound, MRI, X-rays, clinical research methods of chronic anterior lateral instability: “front drawer” test, “supination test”, “titltest”, “pronation test”. The artile shows classification of AOFAS scale. Historical background of operational techniques and their various modifications in chronic anterior lateral instability of the ankle are highlighted, showing the results before and after presentated operating procedures. Tactic of conservative treatment is marked. There are presented results of open and closed types of anatomical and nonatomical stabilization damaged front-fibular ligament the talus. The results of operations of the tendon tenodesis short and long tibial muscles and Brostroma operations and their modifications, as well as modern operating arthroscopic surgery of this pathology, are described. Marked are the advantages and disadvantages of the anatomical and nonanatomicalstabilization of damaged front-fibular ligament of the talus. During instability of the ankle joint young patients with high physical activity, involved in sports, with concomitant rupture of the anterior talo-fibular and calcaneal-fibular ligaments - the treatment method is tenodesis of outer ligament complex form the semitendinosus tendon with tunneling in the fibula, calcaneus and talus. For patients with low physical activity, not involved in sports, whose professional activity is not associated with heavy physical work, it is possible to perform the Brostroma-Gould operation - to create duplikatury local fabrics. Non anatomical ankle stabilization operations, including tenodesis tendons, often lead to disruption of gait and foot inversion restriction and are not recommended for widespread use.
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