Sammarco G J, DiRaimondo C V
Department of Orthopaedic Surgery, University of Cincinnati Medical Center, Ohio.
Am J Sports Med. 1988 Sep-Oct;16(5):501-11. doi: 10.1177/036354658801600513.
Lateral ankle instability syndrome is defined by pain and instability caused by ligament laxity. Anterior talofibular ligament laxity, with or without calcaneofibular laxity and other abnormalities, is often present in conjunction with peroneus brevis tendon tears, abnormal ligament placement, tibialis posterior tendon tears, osteochondritis dissecans, arthritis, synovitis, loose bodies, and tarsal coalition. Surgical reconstructions were performed on 43 ankles using a split peroneus brevis tendon graft routed through osseous tunnels in the talus, fibula, and calcaneus and resutured to the reconstructed anterior talofibular and calcaneofibular ligaments. The tunnel locations, transfer routes, and tendon reinforcement were modifications based on the Elmslie procedure. Good and excellent results were achieved in 91% of the patients. Ninety-eight percent of the patients achieved stability. Followup was from 9 months to 11 years. Twenty-one patients had preoperative and intraoperative findings that required additional procedures. Thorough evaluation of patients with lateral ankle instability syndrome increases the frequency of finding associated abnormalities, which if left uncorrected, may adversely affect the outcome of surgery.
外侧踝关节不稳定综合征的定义是由韧带松弛引起的疼痛和不稳定。距腓前韧带松弛，伴或不伴有跟腓韧带松弛及其他异常，常与腓骨短肌腱撕裂、韧带位置异常、胫后肌腱撕裂、剥脱性骨软骨炎、关节炎、滑膜炎、游离体及跗骨联合并存。对43例踝关节进行了手术重建，采用劈开的腓骨短肌腱移植物，经距骨、腓骨和跟骨的骨隧道穿出，重新缝合至重建的距腓前韧带和跟腓韧带。隧道位置、转移路径和肌腱加强是基于埃尔姆斯利手术的改良。91%的患者取得了良好和优异的效果。98%的患者实现了稳定。随访时间为9个月至11年。21例患者的术前和术中检查结果需要额外的手术。对外侧踝关节不稳定综合征患者进行全面评估会增加发现相关异常的频率，如果不加以纠正，可能会对手术结果产生不利影响。
