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Dae-Wook Kim, Ki-Sun Sung
Abstract
Chronic lateral ankle instability is a major complication of acute ankle sprains, which can cause discomfort in both daily and sports activity. In addition, it may result in degenerative changes to the ankle joint in the long term. An accurate diagnostic approach and successful treatment plan can be established based on a comprehensive understanding of the concept of functional and mechanical instability. The patients' history and correct physical examination would be the first and most important step. The hindfoot alignment, competence of the lateral ligaments, and proprioceptive function should be evaluated. Additional information can be gathered using standard and stress radiographs. In addition, concomitant pathologic conditions can be investigated by magnetic resonance imaging. Conservative rehabilitation composed of the range of motion, muscle strengthening, and proprioceptive exercise is the main treatment for functional instability and mechanical instability. Regarding the mechanical instability, surgical treatment can be considered for irresponsible patients after a sufficient period of rehabilitation. Anatomic repair (modified Broström operation) is regarded as the gold standard procedure. In cases with poor prognostic factors, an anatomical reconstruction or additional procedures can be chosen. For combined intra-articular pathologies, arthroscopic procedures should be conducted, and arthroscopic lateral ligament repair has recently been introduced. Regarding the postoperative management, early functional rehabilitation with short term immobilization is recommended.
Figures and Tables
Table 1
Standard Inclusion Criteria Endorsed, as a Minimum, by the International Ankle Consortium for Enrolling Patients That Fall within the Heterogeneous Condition of Chronic Ankle Instability in Controlled Research
Reused from the article of Gribble et al. (Br J Sports Med. 2014;48:1014-8)5) with original copyright holder's permission.
Table 2
Standard Exclusion Criteria Endorsed, as a Minimum, by the International Ankle Consortium for Enrolling Patients That Fall within the Heterogeneous Condition of Chronic Ankle Instability in Controlled Research
Reused from the article of Gribble et al. (Br J Sports Med. 2014;48:1014-8)5) with original copyright holder's permission.
Table 3
Information Recommended by the International Ankle Consortium for Patients with Chronic Ankle Instability in Order to Provide a Comprehensive Description of the Study Participants That Have Been Enrolled in Controlled Research Studies
Reused from the article of Gribble et al. (Br J Sports Med. 2014;48:1014-8)5) with original copyright holder's permission.
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