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General Orthopaedics

DYNAMIC ANKLE STABILISATION USING EXTENSOR DIGITORUM BREVIS MUSCLE TRANSFER: A SINGLE SURGEON CASE SERIES

The Indian Orthopaedic Society (UK) (IOSUK)



Abstract

Introduction

Extensor digitorum brevis (EDB) transfer is a useful method for treating chronic ankle instability in selected patients. It adds strength to the anterolateral capsule and provides proprioceptive feedback to functionally unstable ankles.

Method

A single surgeon of case series of patients undergoing EDB transfer for chronic ankle instability following sporting injuries between January 2003 and July 2011 was reviewed. All patients underwent arthroscopic procedures in a day case setting. Outcomes were measured using return to sporting activity and the Karlsson functional scoring system.

Results

67 patients underwent unilateral EDB transfer over the 102 month period. 49 patients were male and all patients were aged less than 45. Minimum follow up was 6 months and all patients were discharged by 15 months (median follow up 9 months). Post operative assessment demonstrated normal range of ankle movements in all cases. At 6 months all patients had returned to sporting activity, achieving pre injury activity by 9 months. Karlsson scores were above 85.3 minor complications were seen - a superficial wound infection, limited paraesthesia of a branch of the superficial peroneal nerve and a case of complex regional pain syndrome which underwent full remission with early multimodal therapy.

Conclusion

This study forms the largest published single surgeon series for EDB transfers. The data contributes to the body of evidence supporting EDB transfers as a safe and effective day case procedure for treatment of chronic ankle instability in selected patients.