[Lateral ligament injury of the anterior ankle joint in sports].

During the last few years adequate therapy of ruptures of the fibular ligaments has been a subject of controversial discussions. Several authors consider operative and functional treatment to be almost equally good. In a retrospective study recent ankle ligament ruptures in 120 athletes were analysed with regard as to how the accident happened, the condition of the used sport shoe and the correlation between radiology and intraoperative findings. All cases were treated operatively because of an instability exceeding 10 degrees in the a.p.-stress X-ray. In a follow-up examination including 80 patients 35 to 46 months after operative reconstruction subjective complaints, ability for sports as well as clinical and radiological findings were taken into consideration. Special attention was paid to the possibility of degenerative lesions after plaster immobilisation and to the results of x-ray stress stability examinations. The result of our study confirmed the superiority of operative reconstruction of a two-ligament-injury including a p.o. cast immobilisation. There were only a few cases with functional impairment or limitation of sports activities. No degenerative change could be detected via x-rays. In respect of literature studies, and based on our results, we recommend an individually adapted therapy concept depending on the special situation of the patient. Our follow-up treatment consists of early functional exercises in a windowed cast and a total immobilisation time with a walking plaster of 4 weeks. Alternative methods like the special shoe by Dr. Spring or functional splints are recommended for exceptional cases only.