Indications of Lateral Ankle Ligament Reconstruction with a Free Tendon and Associated Evidence

Hwa-Jun Kang; Hong-Geun Jung

doi:10.14193/jkfas.2018.22.3.91

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Kang and Jung: Indications of Lateral Ankle Ligament Reconstruction with a Free Tendon and Associated Evidence

Review Article

J Korean Foot Ankle Soc 2018;22(3):91-94.

Published online: 20 January 2018

DOI: https://doi.org/10.14193/jkfas.2018.22.3.91

Indications of Lateral Ankle Ligament Reconstruction with a Free Tendon and Associated Evidence

Hwa-Jun Kang, Hong-Geun Jung

Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, ∗Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Korea

Corresponding Author: Hong-Geun Jung Department of Orthopedic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: 82-2-2030-7746, Fax: 82-2-2030-7749, E-mail: jungfoot@hanmail.net ORCID: https://orcid.org/0000-0001-8127-545X

Received 19 August 2018 Revised 9 September 2018 Accepted 10 September 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ankle sprain is one of the most common musculoskeletal injuries. Although most ankle sprains respond well to conservative measures, chronic instability following an acute sprain has been reported to occur in 20% to 40% of patients. Some individuals are eventually indicated for a lateral ankle ligament reconstruction due to persistent ankle instability. More than 80 surgical procedures have been described to address lateral ankle stability. These range from direct repair of the anterior talofibular ligament (ATFL) and of the calcaneofibular ligament (CFL) to reconstructions based on the use of autograft or allograft tissues. However, the best surgical option remains debatable. The modified Broström procedure is most widely used for direct ligament repair, but not always possible because of the poor ATFL or CFL quality or deficiency of these ligaments, which prevents effective shortening imbrication. Furthermore, the importance of a CFL reconstruction has been emphasized recently. On the other hand, it is difficult to achieve an efficient CFL reconstruction during the Broström procedure. Others have reported that an anatomic reconstruction of injured ligaments restores the normal resistance to anterior translation and inversion without restricting subtalar or ankle motion, and as a result, anatomic reconstructions for lateral ankle instability utilizing an autograft or allograft tendon have gained popularity.

Keywords: Ligament reconstruction, Sprain, Instability, Free tendon

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Figure 1.

Schematic diagram of the anatomical reconstruction of the anterior talofibular ligament and calcaneofibular ligament using free tendon and biotenodesis screws.

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