[Late results of surgical treatment of chronic anterolateral instability of the proximal ankle joint].

In the literature more than 30 methods of syndesmoplastic surgery are described for the treatment of chronic ligament instability in the ankle. The aim of our investigation was, on the basis of long-term results, to determine which surgical method has the least complications, which offers the best chances from the viewpoint of exercise and sports, and whether degenerative changes in the joint can be avoided by restitution of stability. By means of isokinetic testing with 36 patients we were able to determine differences in the long-term results of various surgical methods, viz. syndesmoplasty using the peroneus brevis muscle as modified by Evans and Watson/Jones, respectively, and periosteal syndesmoplasty. In the period from 1980 through 1990, at the Graz Hospital for Trauma Surgery we performed 77 syndesmoplastic operations on 75 patients suffering from chronic ligament instability in the ankle joint. Of these cases, 45 were followed up for 6-136 months after the operation. On the basis of the results of these postoperative examinations we recommend periosteal syndesmoplasty for management of chronic ligament instability in the ankle, as this method is relatively easy to perform, prevents post-traumatic arthrosis, ensures maximum stability, which consequently means a low complication rate, and shows favorable final results in isokinetic testing.