Bandverletzungen am oberen Sprunggelenk

Ligamentous instability in the ankle frequently leads to chronic synovitis, cartilage lesions and osteophyte formation, which may degenerate into posttraumatic arthritis. Lesions of the distal tibiofibular syndesmosis are significant for the biomechanics of the ankle when the interosseous tibiofibular ligament is ruptured. Accurate reduction of the fibula to reposition it in the tibial incision and temporary fixation with a syndesmosis screw are essential if healing in the anatomical position is to be achieved. For treatment of a chronic instability of the distal tibiofibular syndesmosis anatomical ligamentoplasty is preferred. In the case of acute lateral ankle ligament ruptures conservative-functional treatment has become established over the last 20 years. Recent meta-analyses have failed to demonstrate any clear superiority of operative treatment, which has the potential for considerable complications. Chronic lateral ankle instability has a favorable prognosis with secondary interventions. Anatomical reconstruction should be given priority over extra-anatomical tenodesis procedures, since the latter are associated with considerable functional restrictions. Isolated ruptures of the deltoid ligaments are rare injuries that heal well with conservative-functional treatment after correct diagnosis.