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Non-anatomical or direct anatomical repair of chronic lateral instability of the ankle: A systematic review of the literature after at least 10 years of follow-up
Authors:Thibaut Noailles  Ronny Lopes  Giovanni Padiolleau  François Gouin  Jean Brilhault
Affiliation:1. Centre Hospitalier Universitaire de Nantes, 1 Place Alexis Ricordeau, 44000 Nantes, France;2. Clinique Brétéché, 3 rue de la Béraudière, 44000 Nantes, France;3. Université F. Rabelais & C.H.R.U Tours, 1 Hôpital Trousseau, 37044 Tours Cedex 09, France
Abstract:

Introduction

A lateral ankle sprain is one of the most frequent reasons for consultation at the emergency trauma unit. Numerous surgical procedures have been described with long-term outcomes that differ.

Hypothesis

The long-term results of anatomical repair of the anterior talofibular ligament (ATFL) and the calcaneofibular (CFL) ligament are better, with less secondary radiological osteoarthritis than non-anatomical repair.

Materials and methods

A review of the literature after a minimum follow-up of 10 years was performed to analyze the clinical and radiological results of direct anatomical repair (Broström, Duquennoy) and non-anatomical repair (Watson Jones, Evans, Castaing). Thirteen articles were selected.

Results

Eight hundred and one ankles were evaluated after a mean follow-up of 15.3 years. The functional outcome was better after anatomical repair but with recurrent instability. Loss of range of motion and secondary osteoarthritis was more frequent after non-anatomical repair.

Conclusion

Anatomical repair of the lateral collateral ligament of the ankle resulted in a better functional outcome and less secondary osteoarthritis than non-anatomical repair.

Study design

Review of the literature; level of proof IV.
Keywords:Lateral ankle instability  Anatomic repair  Lateral reconstruction  Long term
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