Abstract
BackgroundAccessory malleolar ossicles are often found in patients with chronic ankle instability. For the large ossicles more than 10mm, there are still uncertainties about the suitable surgical option.This study was aimed at evaluating the clinical efficacy of ossicle resection and anatomic reconstruction of the lateral ligaments for chronic ankle instability with large accessory malleolar ossicles.MethodsSixteen chronic ankle instability patients with large accessory malleolar ossicles were treated with ossicle resection and anatomic reconstruction of lateral ligaments between December 2014 and February 2018. The clinical effects were evaluated with Visual Analogue Scale, Karlsson-Peterson ankle scoring system, and subjective satisfaction of patients. The varus talar tilt angle and anterior talar displacement between bony surfaces of the tibia and talus were included as radiographic parameters.ResultsThere were 11 males and 5 females in this study group. The average age at the time of surgery was 28.9 years old. The average final follow-up time was 26.9 months (range, 12 to 47). The average size of the ossicles was 11.7mm. The VAS score declined from 3.5 ± 1.6 preoperatively to 1.4 ± 1.0 at the final follow up (p < 0.01). The Karlsson-Peterson score was significantly improved from 52.7 ± 15.1 before surgery to 86.4 ± 8.2 at the last follow up (p < 0.01). Radiologically, the average varus talar tilt angle was decreased from 15.4 ± 2.0 degrees preoperatively to 6.2 ± 1.6 degrees at the final follow up (p < 0.01), and the average anterior talar displacement was decreased from 14.3 ± 2.1 mm preoperatively to 6.3 ± 1.4 mm at final follow up (p < 0.01). Fourteen patients (87.5%) were satisfied (‘excellent’ or ’good’) with treatment outcome.ConclusionsOssicle resection and anatomic reconstruction of the lateral ligaments provided good clinical outcomes for chronic ankle instability with large accessory malleolar ossicles. This method appears to be one of the reliable and effective procedures for the treatment of chronic ankle instability with large accessory malleolar ossicles.
Re: Anatomical reconstruction of the lateral ligaments using Gracillis tendon in chronic ankle instability; a new technique [Foot Ankle Surg 2011;17(4):239–46]
