Nonsurgical Treatment of Lateral Ligament Injury of the Ankle Joint

Foot & Ankle ◽  
1993 ◽  
Vol 14 (9) ◽  
pp. 500-504 ◽  
Author(s):  
Haruyasu Yamamoto ◽  
Toshiro Ishibashi ◽  
Takeshi Muneta ◽  
Kohtaro Furuya
Keyword(s):  
Ankle Joint ◽  
Functional Results ◽  
Plaster Cast ◽  
Nonsurgical Treatment ◽  
Good Stability ◽  
Ligament Injury ◽  
Lateral Ligament ◽  
Stress Radiographs ◽  
Lateral Ligament Injury

Between 1986 and 1989, 40 patients with acute lateral ligament injury of the ankle joint were treated by immobilizing their affected feet in a plaster cast with a heel for 4 weeks, followed by a brace for the next 2 months. The average follow-up time was 29 months. Ninety-eight percent of the patients were rated as having satisfactory functional results. Stress radiographs at the latest follow-up showed good stability even in ankles that were severely unstable at injury. Posttreatment stress radiographs taken periodically showed that stability was maintained 6 months after treatment.

scholarly journals The Broken “Ring of Fire”: A New Radiological Sign as Predictor of Syndesmosis Injury?

2017 ◽  
Vol 5 (3) ◽  
pp. 232596711769506 ◽  
Author(s):  
James Calder ◽  
Adam Mitchell ◽  
Adam Lomax ◽  
Moez S. Ballal ◽  
John Grice ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Distal Tibia ◽  
Interosseous Membrane ◽  
Ligament Injury ◽  
Lateral Ligament ◽  
Ankle Sprains ◽  
Radiological Sign ◽  
Syndesmosis Injury ◽  
Significant Difference ◽  
Lateral Ligament Injury

Background: Subcircumferential periosteal edema above the ankle joint is frequently present on magnetic resonance imaging (MRI) with syndesmosis injuries but has not been previously reported. Fluid height within the interosseous membrane also has not previously been shown to be associated with syndesmosis injury severity. Purpose: To investigate whether a new sign on MRI and measurement of the length of fluid within the interosseous membrane above the ankle may be used to enable identification of a syndesmosis injury and allow differentiation from lateral ligament injury. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Three groups of patients (those with an isolated syndesmosis injury [SI group], isolated lateral ligament injury [LLI group], and no injury [NI group]) who had an ankle MRI for another reason were identified from a patient notes database and the MRI scans retrieved. The scans were anonymized and independently assessed by 8 clinicians (surgeons and radiologists) who were blinded to the diagnosis. The maximum length of fluid above the ankle within the intraosseous membrane was measured for each patient. The presence or absence of distal anterior, lateral, and posterior tibial periosteal edema was recorded (broken “ring of fire”). Results: Measurement of the length of fluid above the ankle had excellent intraobserver reliability (intraclass correlation coefficient, 0.97; 95% CI, 0.93-0.99) but poor interobserver reliability. Fluid extended higher in both the LLI group ( P = .0043) and SI group ( P = .0058) than the NI group, but there was no significant difference between the LLI and SI groups ( P = .3735), indicating that this measurement cannot differentiate between the injuries. The presence of the broken “ring of fire” around the distal tibia was significantly more frequent in the SI group when compared with both LLI and NI groups ( P < .00001). The sensitivity of this sign is 49%, but when present, this sign has a 98% specificity for syndesmosis injury. Conclusion: The presence of tibial subcircumferential periosteal edema 4 to 6 cm above the ankle joint (the “ring of fire”) is highly suggestive of a syndesmosis injury. This new radiological sign can assist with early identification of such injuries. The measurement of height of fluid above the ankle within the interosseous membrane is variable and cannot differentiate severe ankle sprains from high ankle sprains involving the syndesmosis.

A Kinematic Study of Ankle Joint Instability Due to Rupture of the Lateral Ligaments

1997 ◽  
Vol 18 (11) ◽  
pp. 729-734 ◽  
Author(s):  
Takeshi Hashimoto ◽  
Suguru Inokuchi
Keyword(s):  
Ankle Joint ◽  
Three Dimensional ◽  
Ligament Injury ◽  
Heel Strike ◽  
Lateral Ligament ◽  
Patients Âgés ◽  
Kinematic Study ◽  
Lateral Collateral Ligaments ◽  
Lateral Ligament Injury ◽  
Kinematic Evaluation

Kinematic analysis of patients who have ruptured the ligaments of the ankle joint was performed to evaluate the function of those ligaments. Ten patients with ruptured lateral collateral ligaments and 10 normal volunteers were examined. Patients’ ages ranged from 17 to 29, averaging 20.9 years old. We performed kinematic evaluation by a three-dimensional optical analytic technique using surface markers. According to our results, the ankles with lateral ligament injury abnormally pronated and rotated externally at the time of heel strike and abnormally supinated and rotated internally during the acceleration phase.

scholarly journals Stress roentogenogram for the lateral ligament injury of the ankle.

1984 ◽  
Vol 32 (4) ◽  
pp. 1184-1187
Author(s):  
M. Fujita ◽  
S. M. Yoh ◽  
T. Norimatsu ◽  
R. Suzuki
Keyword(s):  
Ligament Injury ◽  
Lateral Ligament ◽  
Lateral Ligament Injury

scholarly journals Location and Morphology of Acute Lateral Ligament Injury of the Ankle

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0031
Author(s):  
Hideo Noguchi
Keyword(s):  
Ankle Instability ◽  
Surgical Reconstruction ◽  
Ligament Injury ◽  
Lateral Ligament ◽  
Ligament Injuries ◽  
Ligament Repair ◽  
Reconstruction Procedure ◽  
Side Body ◽  
Lateral Ligament Injury ◽  
Almost All

Category: Ankle, Sports, Trauma Introduction/Purpose: Acute ankle ligament injuries are usually treated non-operatively, even if the injury is severe. However, when chronic ankle instability is symptomatic, operative treatment is required. When planning local repair, the condition of the remaining ligament is important. We surgically treated acute severe lateral ligament injuries in 103 ankles and investigated the locations of the injuries in the anterior talofibular (ATF) and calcaneofibular (CF) ligaments, subdividing each into three parts. This paper should facilitate more precise planning of the surgical reconstruction procedure. Methods: From 2006 to 2014, 1,042 patients visited our outpatient clinic with a diagnosis of acute lateral ligament injury of the ankle. In total, 103 feet underwent surgical treatment and the locations of the ATF and CF ligament ruptures were investigated. The rupture location in the ATF ligament was subclassified as fibular side, body, or talar side, while for the CF ligament it was classified as fibular side, body, or calcaneal side. Results: The ATF ligament was ruptured on the fibular side in 38 feet (36.9%), body in 30 feet (29.1%), and talar side in 35 feet (34.0%). The CF ligament was ruptured on the fibular side in 15 feet (14.6%), body in 26 feet (25.2%), and calcaneal side in 62 feet (60.2%). Conclusion: Almost all surgical reports on lateral ligament reconstruction procedures (Brostrom et al.) describe ATF ligament repair and advancement on the fibular side, although only one-third of the ligaments were injured on the fibular side in our series. About two-thirds of the CF ligaments had damage to the calcaneal side structure of the entheses. When CF ligament repair is needed, surgeons should be aware of our finding that this ligament was ruptured at the fibular attachment in only 15% of cases, and on the calcaneal side in 60%. This knowledge should lead to better results of surgical reconstruction.

scholarly journals Reefing of the Joint Capsule for Chronic Lateral Ligament Injury of the Ankle.

1998 ◽  
Vol 47 (1) ◽  
pp. 327-332
Author(s):  
Tatsukuni Namihira ◽  
Kouhei Ise ◽  
Katsushi Kudou
Keyword(s):  
Joint Capsule ◽  
Ligament Injury ◽  
Lateral Ligament ◽  
Lateral Ligament Injury

The Role of Calcaneofibular Ligament Injury in Ankle Instability: Implications for Surgical Management

2018 ◽  
Vol 47 (2) ◽  
pp. 431-437 ◽  
Author(s):  
Kenneth J. Hunt ◽  
Helder Pereira ◽  
Judas Kelley ◽  
Nicholas Anderson ◽  
Richard Fuld ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Ankle Joint ◽  
Contact Area ◽  
Ankle Instability ◽  
Peak Torque ◽  
Ligament Injury ◽  
Lateral Ligament ◽  
Anterior Talofibular Ligament ◽  
Ankle Sprains ◽  
Calcaneofibular Ligament

Background: Acute inversion ankle sprains are among the most common musculoskeletal injuries. Higher grade sprains, including anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) injury, can be particularly challenging. The precise effect of CFL injury on ankle instability is unclear. Hypothesis: CFL injury will result in decreased stiffness, decreased peak torque, and increased talar and calcaneal motion and will alter ankle contact mechanics when compared with the uninjured ankle and the ATFL-only injured ankle in a cadaveric model. Study Design: Descriptive laboratory study. Methods: Ten matched pairs of cadaver specimens with a pressure sensor in the ankle joint and motion trackers on the fibula, talus, and calcaneus were mounted on a material testing system with 20° of ankle plantarflexion and 15° of internal rotation. Intact specimens were axially loaded to body weight and then underwent inversion along the anatomic axis of the ankle from 0° to 20°. The ATFL and CFL were sequentially sectioned and underwent inversion testing for each condition. Linear mixed models were used to determine significance for stiffness, peak torque, peak pressure, contact area, and inversion angles of the talus and calcaneus relative to the fibula across the 3 conditions. Results: Stiffness and peak torque did not significantly decrease after sectioning of the ATFL but decreased significantly after sectioning of the CFL. Peak pressures in the tibiotalar joint decreased and mean contact area increased significantly after CFL release. Significantly more inversion of the talus and calcaneus as well as calcaneal medial displacement was seen with weightbearing inversion after sectioning of the CFL. Conclusion: The CFL contributes considerably to lateral ankle instability. Higher grade sprains that include CFL injury result in significant decreases in rotation stiffness and peak torque, substantial alteration of contact mechanics at the ankle joint, increased inversion of the talus and calcaneus, and increased medial displacement of the calcaneus. Clinical Relevance: Repair of an injured CFL should be considered during lateral ligament reconstruction, and there may be a role for early repair in high-grade injuries to avoid intermediate and long-term consequences of a loose or incompetent CFL.

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