• Title/Summary/Keyword: Ankle instability

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Effectiveness of arthroscopic procedure combined with Brostrom one (만성 족관절 외측 불안정성에서 변형 Brostrom 술식과 동시에 시행한 관절경적 치료의 유용성)

  • Yoo, Yon-Sik;Lee, Sang-Soo;Jeung, Eun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.201-207
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    • 2003
  • Purpose: We reviewed the value of treatment for chronic lateral instability of theankle with arthroscopic procedure combined with Brostrom one. Material and Method: From May 2000 to June 2002, 18 patient with chronic lateral instability of the ankle with Modified Brostrom procedure and arthroscopic one. Mean follow-up period was 18 months. Result: Chronic lateral instability of the ankle almost had intraarticular pathology, such as osteophye, osteochondral lesion, So we could resolve intraarticular pathology by arthroscopic procedure during Brostrom one for lateral collateral ligament reconstruction. Conclusion: Modified Brostrom procedure and arthroscopic one are an excellent treating method for chronic lateral instability of the ankle which has intraarticular pathology.

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Is Subtalar Joint Instability an Important Consideration When Treating Ankle Joint Instability? (거골하관절 불안정성이 족관절 불안정성을 치료하는 데 중요한 요소로 작용할까?)

  • Lee, Hyobeom;Kim, Gab-Lae;Kim, Donghyeon
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.38-45
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    • 2021
  • Subtalar joint instability (STI) is one of the causes of persistent hindfoot pain even after treatment for ankle instability. Diagnosis of STI is often neglected because it is a poorly understood concept. However, understanding of the anatomy and injury mechanism of the subtalar joint is a prerequisite of appropriate treatment. Patients with STI usually complain of several symptoms, such as recurrent sprains or a giving way sensation and rolling over. Recently, various diagnostic tools and treatment methods have been investigated. This study was undertaken with the aim of helping clinicians by providing a comprehensive understanding of STI.

Spiral Taping Improves Performance on Star Excursion Balance Test in Individuals with Unilateral Chronic Ankle Instability

  • Bae, Young-Sook
    • The Journal of Korean Physical Therapy
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    • v.28 no.6
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    • pp.376-380
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    • 2016
  • Purpose: This study was to investigate the short-term effects of spiral taping (ST) on performance on the star excursion balance test (SEBT) in individuals with unilateral chronic ankle instability (CAI). Methods: This study was single-group pre - post measures experimental design. The subjects with CAI were 39 (range, 20-31 years; male 16, females 23) were enrolled in the study. The discomfort had in unilateral ankle and Cumberland ankle instability score was 19.56 (${\pm}3.29$). Spiral tape (a width of 3 mm) was applied $3{\times}4$ cross shape on medial malleolus, lateral malleolus and dorsal of talocural joint of unstable ankle. SEBT was measured baseline and 30 min later in stable ankle and unstable ankle. Results: SEBT showed significantly improved after applying the ST (p<0.05, ES=0.74) on unstable ankle. In comparison the difference of stable and unstable ankle, between the pretest and posttest were significant differences (p<0.01, ES=1.88). Conclusion: These results indicated that ST improves performance on the SEBT. Therefore, it suggests that ST may be a suitable intervention to dynamic balance in patients with CAI.

Indications of Lateral Ankle Ligament Reconstruction with a Free Tendon and Associated Evidence (유리건을 이용한 족관절 외측 인대 재건술의 적응증과 근거)

  • Kang, Hwa-Jun;Jung, Hong-Geun
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.91-94
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    • 2018
  • 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 $Brostr{\ddot{o}}m$ 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 $Brostr{\ddot{o}}m$ 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.

Stress Radiographs under Anesthesia for Painful Chronic Lateral Ankle Instability (동통을 동반한 족관절의 만성 외측 불안정성에 있어서 마취하 스트레스 방사선 검사)

  • Choi, Jun Young;Ahn, Hee Chan;Shin, Myung Jin;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.12-16
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    • 2017
  • Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

The Effects of Ankle Taping on Ankle Angular Velocity, Ground Reaction Force and Postural Stability during Jump Landing on Athlete with Functional Ankle Instability (기능적 발목 불안정성을 가진 선수에게 발목 테이핑이 점프 후 착지 시 발목 각속도, 지면반력과 자세 안정성에 미치는 영향)

  • Kim, Kyoung-Hun;Cho, Joon-Heang
    • Korean Journal of Applied Biomechanics
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    • v.19 no.3
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    • pp.519-528
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    • 2009
  • The effects of taping on the use of such measures for prevention have already been comprehensively described in the literature. However, few studies have analyzed ground reaction forces and postural stability with functional ankle instability subject during dynamic activities with ankle taping The purpose of this study was to identify the effects of ankle taping on ground reaction force and postural stability during jump landing. Fourteen players who has ankle instability were participated in this study. we used vicon and force platform. The application of taping who has ankle instability decreased DF and inversion angular velocity and peak vertical ground reaction force during landing. It also improved A-P cop, M-L cop in stability. The findings of this study support the use of taping as part of injury prevention for subject with functional ankle instability in clinical setting.

Effect of acute ankle mobility exercise program on ankle range of motion and pain in adult women with chronic ankle instability : Pilot study (일회성 발목가동성 운동프로그램이 만성발목불안정성을 가진 성인여성들의 발목가동범위와 통증에 미치는 영향-Pilot study)

  • Seung-Eun Kim;Dong-Joo Hwang;Yong-chul Jang;Tae-Kyung Kim;Joon-Yong Cho;Jung-Hoon Koo
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.6
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    • pp.1259-1267
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    • 2023
  • The purpose of this study was to investigate the effects of a acute ankle mobility exercise (AE) program on the range of motion and pain levels associated with chronic ankle instability (CAI). Twenty adult women with an average score of 24 or less on both sides in the ankle instability questionnaire were selected and divided into two groups: the Ankle Mobility Exercise Program group (AE, n=10) and the control group (CON, n=10). The AE treatment involved a one-time, 20-minute exercise session for each ankle, conducted separately on the left and right ankles, to examine the response to a acute exercise. Measures of ankle instability, pain, and ankle range of motion were evaluated before and after the treatment. In the AE group, which underwent the AE program, a significant decrease in pain was observed post-AE compared to pre-AE (p<.01). In addition, an increase in dorsiflexion was observed in the AE group post-AE compared to pre-AE following the AE program(p<.05). These results suggest that a acute AE program can effectively alleviate some aspects of ankle instability by improving ankle pain and range of motion in adult women with chronic ankle instability (CAI).

Impact of Combined Muscle Strength and Proprioceptive Exercises on Functional Ankle Instability

  • Kim, Ki Jong
    • Journal of International Academy of Physical Therapy Research
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    • v.4 no.2
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    • pp.600-604
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    • 2013
  • The purpose of this study was to implement a program of combined muscle stregth and proprioceptive exercises and to examine the impacts of these exercises on functional ankle instability(FAI). Experiments were conducted with 30 adult males and females in their 20s, and the exercise programs were implemented three days per week for four weeks. FAI was defined as a feeling of giving way after an ankle sprain and having a Cumberland ankle instability tool score of 24 points or less. The study subjects were randomly assigned to either a control group, a muscle-strengthening exercise group, or a combined muscle-strengthening and proprioceptive exercise group consisting of 10 subjects each. A Biodex isokinetic dynamometer was used to assess the subjects'ankle strength at selected speeds of $60^{\circ}/sec$ and $120^{\circ}/sec$. The peak torque % body weight showed significant differences in plantar flexion, dorsiflexion, inversion, and eversion. There were also significant differences in proprioception. The results suggest that applying combined muscle-strength and proprioceptive exercises to subjects with FAI is a more effective intervention than applying only muscle-strengthening exercises.

Early Unrestricted Weight-Bearing in a Stirrup Brace Following the Broström Procedure with Suture Tape for Chronic Lateral Ankle Instability (족관절 외측의 만성 불안정성에 Broström 술식과 Suture Tape을 이용한 보강술 후 조기에 시행한 등자보호대 착용 및 체중부하 보행)

  • Jaeyoung, Lee;Geon-Ho, Kwon;Jin-Wha, Chung
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.4
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    • pp.171-176
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    • 2022
  • Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Brostrom procedure with suture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Brostrom procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, including American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS decreased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demonstrated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion: Early unrestricted weight-bearing in a stirrup brace following the Brostrom procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.

Surgical Treatment of Chronic Lateral Ankle Instability: Repair versus Reconstruction (만성 족관절 외측 불안정성의 수술적 치료: 봉합술과 재건술의 비교)

  • Kim, Keun Soo;Park, Young Uk
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.1-5
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    • 2019
  • Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.