Abstract
Introduction and purpose: Numerous surgical procedures have been developed for the treatment of chronic ankle instability, which can be broken down into two: tenodesis of the peroneus brevis and ligament capsuloplasty. We assess the indications for these procedures, discuss their advantages and disadvantages based on a comparative review, and describe an algorithm in the treatment of this pathology.
Materials and methods: We reviewed 21 patients who underwent surgery from 1997 to 2001. In 10 of the patients the operation consisted of a Castaing II procedure with tenodesis of the peroneus brevis, and in 11 a Larsson procedure was performed as a ligament capsuloplasty. The ankle was evaluated using the AOFAS scale.
Results: The age difference between the two groups, which was 40 for those undergoing the Castaing II procedure and 28 for the Larsson technique. The mean AOFAS score was 80% (min. 70%, max. 95%) for the Castaing II procedure and 86% (min. 71%, max. 97%) for the Larsson technique.
Conclusions: The use of tenodesis with the peroneus brevis is indicated for severe ankle instability, failed anatomical repairs and in patients with connective tissue pathology. A capsuloplasty that attempts to reconstruct the lateral ligaments of the ankle as anatomically as possible is indicated for mild-to-moderate chronic instability in young patients.
The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief, Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos 108, 28015-Madrid, Spain
