• 제목/요약/키워드: Lateral ankle instability

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

  • 이재영;권건호;정진화
    • 대한족부족관절학회지
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    • 제26권4호
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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.

동종 아킬레스건을 이용한 만성 족관절 불안정성의 외측인대 재건술 -2예 보고- (Lateral Ankle Ligament Reconstruction using Achilles Allograft for Chronic failed Instability - Two Cases Report -)

  • 주석규;서진수
    • 대한족부족관절학회지
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    • 제9권2호
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    • pp.197-200
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    • 2005
  • We performed lateral ankle ligament reconstructions using Achilles allograft on patients who had failed previous Brostrom repair. The bone plug is fixed with an interference screw into the calcaneus, the tendon graft is passed through a fibular tunnel, and then anchored into the talus with the biotenodesis screw. The graft is strong enough to maintain joint stability until graft incorporation and remodeling occurs. In patients with chronic failed lateral ankle instability requiring graft for ligament reconstruction, this technique allows anatomic reconstruction without the need to sacrifice autogenous peroneal tendons.

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Broström 술식과 비골 골막 젖힘 보강술로 치료한 구상 발목관절에 동반된 족근관절 외측 불안정증: 증례 보고 (Broström Procedure and Fibula Periosteal Turn Down Augmentation for the Ball-and-Socket Ankle Accompanying Lateral Ankle Instability: A Case Report)

  • 신우진;조홍만;박지연
    • 대한족부족관절학회지
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    • 제24권2호
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    • pp.98-101
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    • 2020
  • We report on the case of a patient with chronic instability of the ball-and-socket ankle joint. The patient, a 21-year-old male, was diagnosed 10 years previously with chronic instability of the ball-and-socket ankle joint. He underwent Broström procedure and augmentation using a periosteal turn down from the fibula for this chronic instability despite having received conservative treatment since the diagnosis. After the procedure, the clinical symptoms of ankle instability were improved and the patient is being periodically followed-up. We report on this case of using a Broström procedure as a treatment option for patients with instability of the ball-and-socket ankle joint with normal range of foot and normal ankle joint alignment without damage in the joint and cartilage.

만성 족관절 외측 불안정성의 관절경적 소견 및 치료 (Arthroscopic Findings and Treatment of Chronic Lateral Ankle Instability)

  • 이승용;김갑래;박덕용
    • 대한족부족관절학회지
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    • 제11권2호
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    • pp.198-203
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    • 2007
  • Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.

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봉합 나사를 이용한 변형 Br$\ddot{o}$strom 술식 및 관절경 검사를 이용한 족관절 외측 불안정성의 치료 (Treatment of Chronic Ankle Lateral Instability using Modified Br$\ddot{o}$strom Procedure with Anchor suture & Arthroscopy)

  • 이진영;김갑래;이은수;박현진
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.175-178
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    • 2009
  • Purpose: To evaluate the result of modified Br$\ddot{o}$strom procedure with anchor suture and explore associate lesion under arthroscopy for chronic lateral instability. Materials and Methods: From May 2005 to March 2009, Retrospective analysis of 126 patients with chronic lateral instability who underwent modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure was done. Mean follow-up period was 13 months. Results: Chronic lateral instability of the ankle almost had local synovitis by arthroscopic examination. There were osteochondral lesion of talus on the anteromedial aspect in 63 cases, on the anterolateral aspect in 25 cases, osteochondral lesion of tibia side in 8 cases, fat hypertrophy of tibiofibular space in 120 cases, anterior fat impingement in 26 cases, intra-articular loose body in 13 cases. Mean Karlsson scoring scale was improve from 53 preoperatively to 91 postoperatively, There were 70 cases excellent, 27 cases good, 26 cases fair, 3 cases poor result according to the Sefton procedure. Conclusion: Modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure are reliable treatment method for chronic ankle lateral instability which has intraarticular pathology.

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동반 손상이 없는 만성 족관절 불안정성 환자에 대한 변형 Brostr$\ddot{O}$m 술식 (The Modified Brostr$\ddot{O}$m Procedure for Chronic Ankle Lateral Instability without associated injury)

  • 이경태;최성이;양기원;배상원;이승환
    • 대한족부족관절학회지
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    • 제6권2호
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    • pp.167-171
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    • 2002
  • Purpose: To analyze the result of Modified Brostr$\ddot{O}$m procedure for Chronic ankle lateral instability without associated injury. Materials and Methods: Forty-one patients(Forty-one feet) diagnosed and operated with chronic ankle lateral instability without associated injury were evaluated retrospectively from June 1995 to December 1999. Twenty-three patients were athletes. For the evaluation of clinical outcome, a subjective grading scale of modified Hamilton was used, and pain relief, relief of instability symptom and anterior drawer test were evaluated. Results: Among forty-one operations, there were six excellent, thirty-five good results as a whole. All cases showed over the grade good. The average time to ordinary life in the non-atheletes was 2.5 months and average time to sport activity in the athletes was 4 months postoperatively. Conclusion: The modified Brostr$\ddot{O}$m procedure seems to be effective method for chronic ankle lateral instability without associated injury.

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외측 발목 불안정성을 치료하지 않으면 어떻게 되는가 (What Happens without Treating Chronic Lateral Ankle Instability)

  • 우승훈;정형진
    • 대한족부족관절학회지
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    • 제25권1호
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    • pp.6-9
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    • 2021
  • The term chronic lateral ankle instability (CLAI) embraces a spectrum of conditions that involve functional and mechanical instability, both in athletes and lower-demand patients. The hallmarks of CLAI are recurrent sprains, persistent pain, and repeated episodes of the ankle giving way. CLAI is the main complication of acute ankle sprains, which can cause discomfort in daily and sports activity. Approximately 10% to 30% of patients with acute ligament ruptures will develop chronic instability over the course of a year from the index injury. An accurate diagnostic approach and successful treatment plan should be established based on a comprehensive understanding of the concept of functional and mechanical instability. Unfortunately, the optimal modality for the management of CLAI is unclear. Even after conservative treatment or surgical intervention, it could result in degenerative changes to the ankle joint in the long term. Thus far, the incidence of ligamentous posttraumatic ankle osteoarthritis was reported to be 13% to 78%. The mean latency time between injury and osteoarthritis was at least 10 to 34.3 years. CLAI is an important pathological condition that can cause discomfort or dysfunction in daily activity in the short term, resulting in joint destruction in the long term. Therefore, it is important to understand the various complications that can occur when CLAI is not treated properly.

Chen 술식을 이용한 족근관절의 만성 외측 불안정에 대한 재건술 (Reconstruction for Chronic Lateral Instability of the Ankle by Chen Method)

  • 이기행;유종민;나기태;공윤배;주인탁
    • 대한족부족관절학회지
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    • 제14권1호
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    • pp.53-57
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    • 2010
  • Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability. Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was $15.3^{\circ}$ preoperatively, and the difference with contralateral normal side was $10.1^{\circ}$. At last follow up, talar tile angle and the difference with contralateral side improved to $5.9^{\circ}$ and $1.3^{\circ}$ respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.

Comparison of the Immediate Effects of Kinesio Taping on the Dynamic Balance of Stable Ankle and Functional Ankle Instability among Young Adults in Their Twenties: a preliminary study

  • Kim, Ki-Jong;Kim, Ju-Hong
    • 대한통합의학회지
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    • 제10권1호
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    • pp.73-79
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    • 2022
  • Purpose : Kinesio taping applied to the ankle varies, and if the overall ankle is taped as much as possible, several effects, including balance, can be expected, but clinically the cost reduction for intervention is very important. Therefore, this study attempted to find out the optimal way to the effect and cost of kinesio taping on ankle dynamic balance. Methods : The subject of this study was 24 university students in their 20s (male: 13, female: 11), who received sufficient explanation of the purpose and method of the study. The Cumberland ankle instability tool (CAIT) questionnaire was used for the degree of ankle instability of the study subjects. If the subject's CAIT score was 28 points or more, it was classified as a stable ankle, and if the score was 24 points or less, it was classified as functional ankle instability (FAI). In this study, Biodex Balance System® measurement equipment was used to calculate the dynamic balance of study participants. The application of kinesio taping was performed by one physical therapist to attach in the same way, and a method of wrapping the ankle joint was applied in the eight-shaped bandage. Results : The results are as follows in before and after taping of the stable ankle and FAI group. There was no significant difference in the overall, anterior-posterior, and medial-lateral stability index. The comparison is as follows between groups for the differences (post-pre value) in before and after the application of kinesio taping. There were no significant differences between groups in all the overall, anterior-posterior, and medial-lateral stability index. Conclusion : In this study, no significant difference in kinesio taping was found in the dynamic balance of stable ankle and FAI (overall, anterior-posterior, and medial-lateral). It is necessary to continue to study ways to find the maximum effect while minimally attaching them to the application method of ankle kinesio taping.