Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi, Italy.
Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy.
Foot Ankle Int. 2020 Dec;41(12):1571-1581. doi: 10.1177/1071100720962803. Epub 2020 Nov 4.
Chronic ankle instability can result from untreated or badly managed acute lateral ankle ligament injuries. Conservative management is the modality of choice for acute lateral ankle ligament injuries, and operative treatment is reserved for special cases. Failure after strict rehabilitation may be an indication for surgery. Several operative options are available, including anatomic repair, anatomic reconstruction, and tenodesis procedures. Anatomic repair can be performed when the quality of the damaged ligaments permits. Anatomic reconstruction with an autograft or allograft should be considered when the torn ligaments are not adequate. Ankle arthroscopy is a useful adjunct to ligamentous procedures, performed at the time of repair to identify and treat intra-articular conditions that may be associated with chronic ankle instability. Tenodesis techniques are not recommended because of their suboptimal long-term results related to the modification of ankle and hindfoot biomechanics. Level V, expert opinion.
慢性踝关节不稳定可由未经治疗或处理不当的急性外侧踝关节韧带损伤引起。对于急性外侧踝关节韧带损伤，保守治疗是首选方法，手术治疗仅适用于特殊情况。严格康复后仍失败可能是手术的指征。有几种手术选择，包括解剖修复、解剖重建和肌腱固定术。当损伤的韧带质量允许时，可以进行解剖修复。当撕裂的韧带不足时，应考虑使用自体或同种异体移植物进行解剖重建。踝关节镜检查是一种有用的韧带手术辅助手段，可在修复时识别和治疗与慢性踝关节不稳定相关的关节内疾病。肌腱固定术不推荐使用，因为其与踝关节和后足生物力学改变相关的长期效果不佳。五级，专家意见。
