Use of Cadaveric Graft in Reconstruction of Peroneus Brevis Rupture and Lateral Ankle Instability

2019 ◽  
Vol 109 (1) ◽  
pp. 70-74
Author(s):  
Cory P. Clement ◽  
Ronald Guberman ◽  
Edward Lee ◽  
Lady P. DeJesus
Keyword(s):  
Ankle Instability ◽  
Ankle Sprains ◽  
Peroneus Longus Tendon ◽  
Lateral Ankle ◽  
Peroneus Longus ◽  
Lateral Ankle Instability ◽  
History Of ◽  
Peroneus Brevis ◽  
End To End

This case study presents a novel technique of end-to-end implantation of cadaver graft for the repair of a complete transversely torn peroneus brevis tendon and partially torn peroneus longus tendon in a 58-year-old woman with chronic lateral ankle instability and associated lateral collateral tears. She had a history of multiple ankle sprains and had previously undergone a failed peroneus brevis tendon retubularization procedure. The use of cadaver graft is well documented in the literature for tendon repairs but not well documented in end-to-end repair of the peroneal tendons. A review of the literature revealed only one 2013 study reporting on the benefits and clinical outcomes of cadaver allograft use in peroneal reconstruction.

Effects of Inversion Perturbation After Step-Down on the Latency of the Peroneus Longus and Peroneus Brevis

2011 ◽  
Vol 27 (4) ◽  
pp. 283-290 ◽  
Author(s):  
Adam C. Knight ◽  
Wendi H. Weimar
Keyword(s):  
Ankle Sprain ◽  
Ankle Sprains ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Peroneus Longus ◽  
Significant Difference ◽  
History Of ◽  
Step Down ◽  
Peroneus Brevis ◽  
High Ankle Sprain

The purpose of this investigation was to determine the effect of different types of ankle sprains on the response latency of the peroneus longus and peroneus brevis to an inversion perturbation, as well as the time to complete the perturbation (time to maximum inversion). To create a forced inversion moment of the ankle, an outer sole with fulcrum was used to cause 25 degrees of inversion at the ankle upon landing from a 27 cm step-down task. Forty participants completed the study: 15 participants had no history of any ankle sprain, 15 participants had a history of a lateral ankle sprain, and 10 participants had a history of a high ankle sprain. There was not a significant difference between the injury groups for the latency measurements or the time to maximum inversion. These findings indicate that a previous lateral ankle sprain or high ankle sprain does not affect the latency of the peroneal muscles or the time to complete the inversion range of motion.

Biomechanical Properties of Commonly Used Autogenous Transplants in the Surgical Treatment of Chronic Lateral Ankle Instability

2002 ◽  
Vol 23 (7) ◽  
pp. 661-664 ◽  
Author(s):  
Michael Bohnsack ◽  
Bert Sürie ◽  
Ludger Kirsch ◽  
Nikolaus Wülker
Keyword(s):  
Ankle Instability ◽  
Biomechanical Properties ◽  
Anterior Talofibular Ligament ◽  
Biomechanical Stability ◽  
Lateral Ankle ◽  
Periosteal Flap ◽  
Peroneus Longus ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Peroneus Brevis

The purpose of this study was to evaluate the biomechanical properties of commonly used autogenous transplants for the surgical stabilization of chronic lateral ankle instability. We dissected the transplants (peroneus longus, peroneus brevis, Achilles and plantaris tendon, periosteal flap, fascia, corium) and the anterior talofibular ligament from 13 fresh anatomic specimens. After laser-assisted measurement of the transplant diameter, we assessed their biomechanical properties with a universal testing device. Biomechanical stability of the peroneus longus, peroneus brevis, and Achilles tendons was significantly higher than the other transplants. The stability parameters of the periosteal flap were in the range of the anterior talofibular ligament but inferior to the tendons. The application of a transplant with low biomechanical stability, such as the periostal flap, requires more postoperative immobilization as in a strong orthosis or cast.

scholarly journals Chronic Peroneal Tendon Dislocation: A Case Report

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1882-e1886
Author(s):  
Kiya Shazadeh Safavi ◽  
Saruthija Ratnasingam ◽  
Cory F Janney
Keyword(s):  
Sports Injury ◽  
Acute Onset ◽  
Peroneal Tendon ◽  
Peroneus Longus Tendon ◽  
Lateral Ankle ◽  
Peroneus Longus ◽  
Patient Reported ◽  
History Of ◽  
Peroneus Brevis

Abstract We present a unique case of chronic peroneal tendon dislocation in a 47-year-old active duty military member with a 2-mo history of acute onset lateral ankle pain due to sports injury. Magnetic resonance imaging revealed superficial peroneal retinaculum (SPR) disruption, a flattened retrofibular groove, dislocation of the peroneus longus tendon, and a tear of the peroneus brevis tendon. The patient was managed operatively with fibular groove deepening, SPR reconstruction, peroneus brevis debridement, and peroneus longus tubulurization. No complications were observed during the intra- or perioperative periods. At their 3-mo follow-up, the patient reported near complete resolution of pain and the ability to ambulate without any brace or support. He returned to running and was able to deploy fit for full duty 4.5 mo from injury.

scholarly journals Lateral Ankle Sprain and Chronic Ankle Instability

2019 ◽  
Vol 4 (2) ◽  
pp. 247301141984693 ◽  
Author(s):  
Aida K. Sarcon ◽  
Nasser Heyrani ◽  
Eric Giza ◽  
Christopher Kreulen
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Invasive Procedures ◽  
Clinical Tests ◽  
Level Of Evidence ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Lateral Ankle Instability ◽  
History Of

A select 10-30% of patients with recurrent lateral ankle sprains develop chronic ankle instability (CAI). Patients with chronic ankle instability describe a history of the ankle “giving way” with or without pathological laxity on examination. Evaluation includes history, identification of predisposing risk factors for recurrent sprains, and the combination of clinical tests (eg, laxity tests) with imaging to establish the diagnosis. There are a variety of nonoperative strategies to address chronic ankle instability, which include rehabilitation and taping or bracing to prevent future sprains. Patients who fail conservative treatment are candidates for surgery. The anatomic approaches (eg, modified Broström) are preferred to nonanatomic procedures since they recreate the ankle’s biomechanics and natural course of the attenuated ligaments. There is a growing interest in minimally invasive procedures via ankle arthroscopy that also address the associated intra-articular disorders. This article provides a review of chronic lateral ankle instability consisting of relevant anatomy, associated disorders, evaluation, treatment methods, and complications. Level of Evidence: Level V, expert opinion.

Peroneus Brevis Tears Associated with Chronic Lateral Ankle Instability

2020 ◽  
pp. 225-233
Author(s):  
Jon Karlsson ◽  
Louise Karlsson ◽  
Eleonor Svantesson ◽  
Eric Hamrin Senorski
Keyword(s):  
Ankle Instability ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Peroneus Brevis

scholarly journals Evaluating and Differentiating Ankle Instability

2019 ◽  
Vol 54 (6) ◽  
pp. 617-627 ◽  
Author(s):  
Phillip A. Gribble
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
High Rate ◽  
Diagnostic Tools ◽  
Ankle Sprains ◽  
Lateral Ankle ◽  
The Status ◽  
History Of ◽  
Ankle Complex

Given the prevalence of lateral ankle sprains during physical activity and the high rate of reinjury and chronic ankle instability, clinicians should be cognizant of the need to expand the evaluation of ankle instability beyond the acute time point. Physical assessments of the injured ankle should be similar, regardless of whether this is the initial lateral ankle sprain or the patient has experienced multiple sprains. To this point, a thorough injury history of the affected ankle provides important information during the clinical examination. The physical examination should assess the talocrural and subtalar joints, and clinicians should be aware of efficacious diagnostic tools that provide information about the status of injured structures. As patients progress into the subacute and return-to-activity phases after injury, comprehensive assessments of lateral ankle-complex instability will identify any disease and patient-oriented outcome deficits that resemble chronic ankle instability, which should be addressed with appropriate interventions to minimize the risk of developing long-term, recurrent ankle instability.

scholarly journals Minimally Invasive Reconstruction of Anterior Talofibular Ligament with Partial Peroneus Brevis Tendon in the Treatment of Chronic Lateral Ankle Instability

2014 ◽  
Vol 1 (1) ◽  
pp. 12-16
Author(s):  
Qian-bo Chen ◽  
Xiao-kang Tan ◽  
Chen-song Yuan ◽  
Xu Tao ◽  
Hong-hui Cao ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Ankle Instability ◽  
Asia Pacific ◽  
Anterior Talofibular Ligament ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Peroneus Brevis

ABSTRACT Background Chronic lateral ankle instability causes significant problems in physical activity and accelerates development of osteoarthritic changes. Many procedures were designed to reconstruct the anterior talo-fibular ligament (ATFL) in the treatment of chronic lateral ankle instability. Although most of them were effective, but brought big trauma and sacrifice of some tendons. Objective To design a minimally invasive ATFL reconstruction with partial peroneus brevis tendon and evaluate its clinical outcomes. Study design Nonrandomized controlled clinical trial. Materials and methods From 2004 to 2012, 29 patients of chronic lateral ankle instability were treated with minimally invasive ATFL reconstruction with partial peroneus brevis tendon. A 3 cm curved incision was made to explore the ATFL origin and its insertion. Half peroneus brevis tendon was taken to reconstruct the ATFL through the bone tunnel from the insertion of CFL to the insertion of ATFL in the fibular, and then fixed to ATFL insertion location on the talus. All patients were followed-up by radiology and clinical examination at least two years. Their ATFLs were always evaluated by standard stress X-ray examination and magnetic resonance imaging (MRI) prior to surgery and every 1 year after the operation. Functional results were assessed in terms of Karlsson score and the American Orthopaedic Foot and Ankle Society (AOFAS) anklehind foot score. Results The average follow-up period was 57.9 months (24- 114 months). The majority of results (93.1%) were satisfactory. The mean Karlsson score improved from 41.7 prior to surgery to 88.6 and AOFAS from an average 47.2 preoperatively to 91.7 postoperatively at the final follow-up visit. Paired t-tests showed improvements of great significance (p < 0.01). The ligaments were proved be reconstructed well in all patients by MRI. It showed the negative talar tilt sign postoperatively by stress X-rays. There was no recurrence of lateral ankle instability. Conclusion The minimally invasive ATFL reconstruction with partial peroneus brevis tendon has advantages of small trauma, good reconstruction and excellent clinical outcomes, thus, is a safe and effective method for the treatment of chronic lateral ankle instability. How to cite this article Chen Q, Tan X, Yuan C, Tao X, Cao H, Xu J, Tang K. Minimally Invasive Reconstruction of Anterior Talofibular Ligament with Partial Peroneus Brevis Tendon in the Treatment of Chronic Lateral Ankle Instability. J Foot Ankle Surg (Asia-Pacific) 2014;1(1):12-16.

Radiologic Evaluation of the Effect of Distal Tibiofibular Joint Anatomy on Arthroscopically Proven Ankle Instability

2019 ◽  
Vol 41 (2) ◽  
pp. 223-228 ◽  
Author(s):  
Muhammet Baybars Ataoğlu ◽  
Mehmet Ali Tokgöz ◽  
Anıl Köktürk ◽  
Yılmaz Ergişi ◽  
Mustafa Yasin Hatipoğlu ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Pearson Correlation ◽  
Clear Understanding ◽  
Ankle Sprains ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Talocrural Joint ◽  
Lateral Ankle ◽  
Lateral Ankle Instability ◽  
Tibiofibular Joint

Background: Ankle sprains occur frequently in both athletes and the general population. The social and economic consequences can be significant. In an effort to understand the injury, dynamic and static structures around the ankle have been investigated in detail, but anatomical factors predisposing to lateral ankle instability have not been fully clarified. The aim of this study was to radiologically investigate the relationship between bony variations of the distal tibiofibular joint and arthroscopically proven ankle instability. Methods: Fifty patients with arthroscopically proven ankle instability and 50 patients without instability were included in this study. Measurements were obtained from a magnetic resonance imaging (MRI) section 1 cm proximal to the tibiotalar joint; distal tibiofibular joint anterior facet length ( a), posterior facet length ( b), angle between the anterior and posterior facets ( c), fibular notch depth ( d), tibia thickness ( e), and fibula thickness ( f) was measured. Results: It was found that instability was more frequent when the length of a ( P < .001) and e ( P < .001) were shorter. In addition, when value of a/ b and e/f were evaluated, it was observed that the number of individuals who had instability increased as the ratio became smaller ( P < .016-.020, respectively). Pearson correlation analysis indicated strong negative correlation between the values of a- e and instability ( r = −0.348, P < .001, and r = −0.328, P = .001; respectively). Conclusion: Lateral ankle sprains are common, and a clear understanding of the relevant structures and clinical function of the ankle complex should extend beyond the talocrural joint. This study demonstrated that the presence of narrow anterior facet ( a) and thinner tibia ( e) were strongly correlated with lateral ankle instability. Level of Evidence: Level III, retrospective case control study.

A Novel Dynamic Ankle-Supinating Device

2010 ◽  
Vol 26 (1) ◽  
pp. 114-121 ◽  
Author(s):  
Gregory M. Gutierrez ◽  
Thomas Kaminski
Keyword(s):  
Ankle Instability ◽  
Control Strategies ◽  
Neuromuscular Control ◽  
Biomechanical Analysis ◽  
Ankle Sprains ◽  
Compensatory Mechanisms ◽  
Lateral Ankle ◽  
History Of ◽  
Underlying Causes ◽  
Insight Into

Lateral ankle sprains (LAS) are among the most common joint injuries, and although most are resolved with conservative treatment, others develop chronic ankle instability (AI). Considerable attention has been directed toward understanding the underlying causes of this pathology; however, little is known concerning the neuromuscular mechanisms behind AI. A biomechanical analysis of the landing phase of a drop jump onto a device that simulates the mechanism of a LAS may give insight into the dynamic restraint mechanisms of the ankle by individuals with AI. Furthermore, work evaluating subjects who have a history of at least one lateral ankle sprain, yet did not develop AI, may help elucidate compensatory mechanisms following a LAS event. Identifying proper neuromuscular control strategies is crucial in reducing the incidence of AI.

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