Diagnosis and treatment of chronic lateral ankle instability with ligamentum bifurcatum injury

Sun, Yong; Wang, Huijuan; Tang, Yuchao; Qin, Shiji; Zhao, Mingyao; Zhang, Fengqi

doi:10.1097/md.0000000000010028

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…Frequently, these copathologies are documented at the time of surgery following unsuccessful nonsurgical management. 13,282 Coexisting pathology accompanying CAI may include: • Fibularis muscle pathology 13,199 • Ankle impingement 13,262 • Osteochondral lesions 13 • Synovitis 282 • Chondral lesions (superficial or deep) 196,265,282 • Bony or avulsion fragments 282,364 • Loose bodies 282 • Syndesmotic injury 65,326 • Arthritis 293 • Bifurcate ligament injury 415 • Symptomatic accessory ossicles, 364 including os trigonum syndrome 98…”

Section: Evidence Updatementioning

confidence: 99%

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Martin¹,

Davenport²,

Fraser³

et al. 2021

J Orthop Sports Phys Ther

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B Clinicians should include patient age, body mass index, pain coping strategies, report of instability, history of previous sprain, ability to bear weight, pain with weight bearing, ankle dorsiflexion range of motion (ROM), medial jointline tenderness, balance, and ability to jump and land (as safely tolerated) in their initial assessment, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with an acute lateral ankle sprain (LAS). CLINICAL COURSE -CHRONIC ANKLE INSTABILITYC Clinicians may include previous treatment, number of sprains, pain level, and self-report of function in their evaluation, as well as an assessment of the sensorimotor movement systems of the foot, ankle, knee, and hip during dynamic postural control and functional movements, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with chronic ankle instability (CAI). DIAGNOSIS/CLASSIFICATION -ACUTE LATERAL ANKLE SPRAINB Clinicians should use special tests, including the reverse anterolateral drawer test and anterolateral talar palpation in addition to the traditional anterior drawer test, and a thorough history and physical examination to aid in the diagnosis of a LAS. DIAGNOSIS/CLASSIFICATION -CHRONIC ANKLE INSTABILITYB When determining whether an individual has CAI, clinicians should use a reliable and valid discriminative instrument, such as the Cumberland Ankle Instability Tool or the Identification of Functional Ankle Instability, as well as a battery of functional performance tests that have established validity to differentiate between healthy controls and individuals with CAI. EXAMINATION -OUTCOME MEASURESA Clinicians should use validated patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System physical function and pain interference scales, the Foot and Ankle Ability Measure, and the Lower Extremity Functional Scale, as part of a standard clinical examination. Clinicians should utilize these before and 1 or more times after the application of interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions associated with an acute LAS or CAI.C Clinicians may use the Pain Self-Efficacy Questionnaire in the acute and postacute periods after a LAS to assess effective coping strategies for pain, and the 11-item Tampa Scale of Kinesiophobia and the Fear-Avoidance Beliefs Questionnaire to assess fear of movement and reinjury and fear-avoidance beliefs in those with CAI. EXAMINATION -PHYSICAL IMPAIRMENT MEASURESA Clinicians should assess and document ankle swelling, ROM, talar translation, talar inversion, and single-leg balance in patients with an acute LAS, postacute LAS, or CAI at baseline and 2 or more times over an episode of care. Clinicians should specifically include measures of dorsiflexion, using the weight-bearing lunge test, static single-limb balance on a firm surface with eyes...

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Section: Evidence Updatementioning

confidence: 99%

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Martin¹,

Davenport²,

Fraser³

et al. 2021

J Orthop Sports Phys Ther

View full text Add to dashboard Cite

show abstract

“…cReferences 2, 4, 6 –9, 12, 13, 15 –17, 19, 20, 25, 28, 35, 40 –45, 51, 57, 58, 64, 67, 69, 72, 73, 76, 77, 79 –81, 85, 86, 96, 98, 109 –111, 114, 117 –119, 132, 136, 142, 144 –146, 154, 156, 164, 166, 168, 170, 174, 179, 180, 185, 191, 194, 196 –…”

mentioning

confidence: 99%

“…eReferences 2, 3, 7, 8, 12, 26 –29, 35, 36, 38, 42 –44, 46, 69, 73, 74, 86, 90, 93, 95, 97, 102, 103, 105, 107, 114, 117 –119, 132, 134, 139, 142, 151, 153, 156, 157, 166, 179, 180, 184, 189, 191, 196, 197, 199, 206, 215, 216, 226, 229, 234.…”

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confidence: 99%

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Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Song

Liu

Sun

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: The surgical management of chronic lateral ankle instability (CLAI) has evolved since the 1930s, but for the past 50 years, the modified Broström technique of ligament repair has been the gold standard. However, with the development of arthroscopic techniques, significant variation remains regarding when and how CLAI is treated operatively, which graft is the optimal choice, and which other controversial factors should be considered. Purpose: To develop clinical guidelines on the surgical treatment of CLAI and provide standardized guidelines for indications, surgical techniques, rehabilitation strategies, and assessment measures for patients with CLAI. Study Design: A consensus statement of the Chinese Society of Sports Medicine. Methods: A total of 14 physicians were queried for their input on guidelines for the surgical management of CLAI. After 9 clinical topics were proposed, a comprehensive systematic search of the literature published since 1980 was performed for each topic through use of China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, EMBASE, and the Cochrane Library. The recommendations and statements were drafted, discussed, and finalized by all authors. The recommendations were graded as grade 1 (strong) or 2 (weak) based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Based on the input from 28 external specialists independent from the authors, the clinical guidelines were modified and finalized. Results: A total of 9 topics were covered with regard to the following clinical areas: surgical indications, surgical techniques, whether to address intra-articular lesions, rehabilitation strategies, and assessments. Among the 9 topics, 6 recommendations were rated as strong and 3 recommendations were rated as weak. Each topic included a statement about how the recommendation was graded. Conclusion: This guideline provides recommendations for the surgical management of CLAI based on the evidence. We believe that this guideline will provide a useful tool for physicians in the decision-making process for the surgical treatment of patients with CLAI.

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“…The severity of this classification system is constantly increasing, pointing out the pathological mechanics that lead to fractures, so it can guide doctors on which method to use for which fixation. In [8], the authors reported the institution's experience in the diagnosis and treatment of chronic branch-ankle instability (CLAI) with ligament ligament (LB) injury. A total of 218 patients with CLAI who underwent continuous surgery from January 2012 to December 2015 were selected.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Acute Lateral Collateral Ligament Injury of Athletes

2020

IJPHPM

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Injury to the lateral collateral ligament of the ankle joint is common in athletes and it accounts for a large portion of cases of emergency sports trauma. Although the ankle ligament injury is not a very serious sports trauma, if it is not handled early, it will seriously affect the athlete's training and may cause severe after-effects. In view of the above problems, this article proposes the treatment of acute lateral ankle joint collateral ligament injury in athletes, in order to provide a reference for related treatment. In this study, 135 patients were admitted from March 2019 to August 2019. The 135 patients with acute lateral collateral ligament injury of the ankle were divided into three groups for comparison experiments. The three groups were conservative treatment group, direct surgical repair group and surgical ligament reconstruction group. The American Foot and Ankle Surgery Association (AOFAS) score was used to evaluate the function of the posterior foot, and the 3 groups of patients were observed for AOFAS scores, clinical effects, and complications before and 12 months after treatment. The results showed that, compared with before treatment, the AOFAS scores of the three groups were significantly improved after treatment (P <0.05). The total AOFAS score and clinical efficacy of patients in the direct surgery repair group and the ligament reconstruction group were significantly better than those in the conservative treatment group (P <0.05). However, the incidence of postoperative complications in the two groups of surgical treatment groups was higher than that of the conservative treatment group, and the difference was statistically significant (P <0.05). There were no significant differences in the total AOFAS score, clinical efficacy, and complication rate between the direct surgery repair group and the ligament reconstruction group (P> 0.05). Therefore, it is believed that the effect of surgical treatment on the improvement of posterior foot function in patients with acute lateral ankle joint collateral ligament injury is more obvious than that of conservative treatment, but the safety is poor. The surgical effects of anchor repair and modified Elmslie are equivalent, so the treatment plan should be determined based on the comprehensive situation.

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Diagnosis and treatment of chronic lateral ankle instability with ligamentum bifurcatum injury

Cited by 6 publications

References 20 publications

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Treatment of Acute Lateral Collateral Ligament Injury of Athletes

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