• 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.

• 대한족부족관절학회지
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• 제13권1호
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• pp.19-22
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• 2009

Purpose: This retrospective study was designed to determine the type and frequency of associated lesions in patients with chronic lateral ankle instability who had modified Brostrom lateral ankle ligament reconstruction. Materials and Methods: Between 2004 and 2007, 60 cases of 60 patients were enrolled in this study. A retrospective review of the magnetic resonance images of the affected ankle was conducted by two orthopedic surgeons who did not get any information about intraoperative findings and the lesions were admitted when two doctors were coincident. Results: The overall incidence of associated lesions found in this study was about 83%. Peroneal tenosynovitis was the highest frequency (32%), followed by osteochondral lesion of talus (28%), anterolateral impingement (15%), Os subfibula (13%), Os trigonum (12%), ankle synovitis (12%), anterior tibiofibular ligament tear (15%), anterior bony spur (7%). Another findings were loose bodies (5%), flexor tendon tenosynovitis (5%), medial osteophyte (3%). Conclusion: Identifying these associated lesions will be helpful in treating chronic lateral ankle instability especially when the surgeon have a plan to operate the instability. We suggest that the better results can be obtained when the associated lesions are corrected simultaneously.

• 대한족부족관절학회지
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• 제10권1호
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• pp.7-10
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• 2006

Purpose: We analyzed the ankle bony abnormality of patients with marked ankle instability who had chronic ankle sprain more than 3 years. Materials and Methods: We evaluated the chronic ankle sprain (more than 3 years) patients with marked ankle instability tested by varus stress test and anterior draw test from March 2000 to December 2005. Eighty-nine patients (104 ankle) were evaluated and there were 38 males and 51 females. The mean age of patient at the time of diagnosis was 34.5 (range, 18 to 56 years). The average duration of morbidity was 7 years and 3 months (range, 3 years and 3 months to 21 years). The patients who had history of dislocation, fracture, malalignment, operated patients, and rheumatoid ones were excluded. Plain radiographs of AP, lateral, oblique and mortise view were checked. Results: Radilologic abnormalities were found at 74 ankles (71%) among 104 ankles. Frequent sequences of location were anterior talotibial osteophyte, medial malleolar osteophyte, Os subfibulare, lateral malleolar osteophyte. Posteior osteophyte, ankle arthritis, talar articular defect were rarely found. Conclusion: Seventy-one percent among patients with chronic ankle sprain and marked ankle instability showed more than one radiologic abnormalities. Thus, more exclusive and accurate ankle examination should be performed in these patients.

• The Journal of Korean Physical Therapy
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• 제34권3호
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• pp.91-97
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• 2022

Purpose: This study investigated the short-term effectiveness of extracorporeal shock wave therapy (ESWT) on pain, the ankle instability, the ankle function, dorsiflexion range of motion (ROM), and dynamic balance in patients with chronic ankle instability (CAI). Methods: Eighteen participants were divided into an experimental (n=9) and control group (n=9). The ESWT in the experimental group was applied to the lateral collateral ligament in combination with the tibialis anterior whereas the ESWT was applied to the lateral collateral ligament of the ankle alone in the control group. Pain, the ankle instability, the ankle function, dorsiflexion ROM, and dynamic balance were measured using the Visual analog scale, Cumberland ankle instability tool, American Orthopedic Foot and Ankle Society ankle-hindfoot score, weight-bearing lunge, and Y-balance test, before and after ESWT intervention. Results: Significant interactions (group × time) and time effects were observed in the dorsiflexion ROM and dynamic balance. Bonferroni's post-hoc analysis showed that the experimental group revealed a more significant change in dorsiflexion ROM and dynamic balance than the control group. There was a significant time effect in the pain, the ankle instability, and the ankle function, but no significant interaction (group × time) was observed. Conclusion: The ESWT could improve the pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI. Furthermore, the ESWT combined with lateral ankle ligaments and tibialis anterior more improves the dorsiflexion ROM and dynamic balance.

• 대한족부족관절학회지
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• 제8권1호
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• pp.81-85
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• 2004

Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

• 한국운동역학회지
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• 제32권1호
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• pp.9-16
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• 2022

Objective: The purpose of this study was to investigate how the chronic ankle instability affects postural control during forward jump landing. Method: 20 women with chronic ankle instability (age: 21.7 ± 1.6 yrs, height: 162.1 ± 3.7 cm, weight: 52.2 ± 5.8 kg) and 20 healthy adult women (age: 21.8 ± 1.6 yrs, height: 161.9 ± 4.4 cm, weight: 52.9 ± 7.2 kg) participated in this study. For the forward jump participants were instructed to stand on two legs at a distance of 40% of their body height from the center of force plate. Participants were jump forward over a 15 cm hurdle to the force plate and land on their non-dominant or affected leg. Kinetic and kinematic data were obtained using 8 motion capture cameras and 1 force plates and joint angle, vertical ground reaction force and center of pressure. All statistical analyses were using SPSS 25.0 program. The differences in variables between the two groups were compared through an independent sample t-test, and the significance level was to p < .05. Results: In the hip and knee joint angle, the CAI group showed a smaller flexion angle than the control group, and the knee joint valgus angle was significantly larger. In the case of ankle joint, the CAI group showed a large inversion angle at all events. In the kinetic variables, the vGRF was significantly greater in the CAI group than control group at IC and mGRF. In COP Y, the CAI group showed a lateral shifted center of pressure. Conclusion: Our results indicated that chronic ankle instability decreases the flexion angle of the hip and knee joint, increases the valgus angle of the knee joint, and increases the inversion angle of the ankle joint during landing. In addition, an increase in the maximum vertical ground reaction force and a lateral shifted center of pressure were observed. This suggests that chronic ankle instability increases the risk of non-contact knee injury as well as the risk of lateral ankle sprain during forward jump landing.

• 대한족부족관절학회지
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• 제25권1호
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• pp.32-37
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• 2021

Patients with chronic lateral ankle instability often experience a range of associated injuries. The well-known comorbidities include intra-articular pathologies (osteochondral lesion, soft tissue or bony impingement, and loose body), peroneal tendon pathologies, neural injuries, and other extra-articular pathologies. Surgeons should have a high index of suspicion for these associated pathologies before operative intervention, correlate the clinical findings, and plan the treatment. Despite the restoration of ankle stability following ligament repair or reconstruction surgery, a high prevalence (13%~35%) of postoperative residual pain has been reported. This pain can negatively affect the clinical outcomes and patient satisfaction. This study examined the causes of persistent pain after surgical treatments for chronic ankle instability.

• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.69-77
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• 2022

Background: Ankle sprains, and the resulting ankle instability worsen to chronic due to recurrent ankle injuries or sprains, 78% of which are accompanied by posture instability and damage due to changes in the position of the talus of the ankle. The purpose of this study is to investigate the immediate effect of applying MWM taping on the patient's muscle strength and balance ability in patients with chronic ankle instability. Methods: 15 people with MWM taping and 15 people with Kinesio taping were applied, and after applying the taping of the ankle, 10 minutes of walking treadmill and 10 times of forward lunge operation, the change in ankle muscle strength and balance ability was confirmed. The strength test of the ankle was performed using a test device called Biodex system 4 (USA) for the movement of the dorsi-flexion and plantar flexion of the foot, and the balance of the two groups was measured using Biodex balance system (USA) to test balance ability. Results: The comparison of muscle strength changes in the ankle does not show a significant increase in the group applying MWM compared to the group applying kinesio taping (p<.05). In the comparison of equilibrium capabilities, the MWM taping group also showed a significant increase in the MWM taping group compared to the kinesio taping group (p<.05). Conclusion: When applying MWM taping and kinesio taping to patients with chronic ankle instability, there was no significant difference in comparison of muscle strength changes, but there was a significant difference in comparison of balance ability.

• 국제물리치료학회지
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• 제11권4호
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• pp.2212-2220
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• 2020

Background: Repetitive damage to the ankle joint causes chronic ankle instability, and studies comparing the effects of exercise in open and closed chains as a treatment method are very rare. Objectives: To investigate the effects of open and closed kinetic exercises on muscle activity and dynamic balance of ankle joint in adults with chronic ankle instability. Design: Single-blind randomized controlled trial. Methods: The selected 30 subjects are randomly divided into open kinetic chain exercise experimental group (EGI, n=10), closed kinetic chain exercise experimental group (EGII, n=10), and stretching control group (CG, n=10). Open and closed kinetic exercises lasted 30 minutes three times a week for six weeks and stretching exercises performed four actions for 20 seconds and five sets. The measurement tools using surface electromyography to measure muscle activity in the ankle joint. The dynamic balance of the ankle was evaluated using the Y-Balance test. Results: Following the intervention, closed and open kinetic chain exercise group showed significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance (P<.05). However, no significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance between closed and open kinetic chain exercise group (P<.05). Conclusion: This study provides evidence that closed and open kinetic chain exercise can be presented as an effective exercise for the muscle activity of ankle muscle and dynamic balance of the subject with chronic ankle instability.

• 한국전문물리치료학회지
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• 제30권4호
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• pp.268-274
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• 2023

Background: Ankle sprains occur frequently among humans who undertake various body movements. Diverse walking environments and dual tasks, that can affect ankle sprains, have been studied. However, there is a lack of research on inter-trial variability according to the changes in gait speed. Objects: The purpose of this study was to compare the adaptive ability of walking between the subjects with chronic ankle instability and healthy adults while performing a walking task with different walking speeds. Methods: In this study, 24 people in the chronic ankle instability group and 24 people in the healthy ankle group were selected as subjects. The length of the pre-measurement and the actual walking measurement were both set to 4.6 m. Once the subjects entered the measurement section, they changed their gait speed according to the randomly assigned speed change. Gait was measured twice and the average value was used for the analysis. Results: The coefficient of variation (CV) of cycle time in subjects with chronic ankle instability showed a significant difference in all cases except when the subjects changed their speed from preferred to slow and from slow to preferred. The CV of step length demonstrated a significant difference in all cases except for the change from slow to preferred and from preferred to fast. The cycle time and step length differential showed a significant difference only when the subjects changed the speed from slow to fast. Conclusion: The subjects with chronic ankle instability were found to have significantly reduced walking adaptability while performing inter-trial variability tasks with different gait speeds compared to healthy subjects.