TY - JOUR
T1 - Ankle instability
T2 - Comparison of primary repair and delayed reconstruction after long-term follow-up study
AU - Cass, J. R.
AU - Morrey, B. F.
AU - Katoh, Y.
AU - Chao, E. Y.S.
PY - 1985/12/1
Y1 - 1985/12/1
N2 - Twenty-five consecutive primary ligament repairs and 40 delayed reconstructions for lateral collateral ankle ligament injuries were studied. Response to a questionnaire provided a 94% subjective evaluation at a mean of 9.5 years after surgery; 97% of patients were satisfied with the surgical result. Clinical examination, stress radiography, and biomechanical gait analysis studies were performed on 39 patients at four years or more after surgery (mean, 9.6 years). In 14% of those with ligament repair and 41% of those with reconstructive procedures, mean residual talar tilt with stress testing was 3.2° and 5.2°, respectively. Gait studies did not demonstrate a consistent abnormal gait pattern, even with side slope walking, and did not correlate with the talar tilt values. There was no significant measurable difference between the results of repair and reconstruction. Thus, most severe Grade III sprains can be managed nonoperatively, and if late residual instability occurs, a reconstructive procedure can be offered with confidence that the result will be equivalent subjectively and roughly comparable objectively to that of the immediate repair.
AB - Twenty-five consecutive primary ligament repairs and 40 delayed reconstructions for lateral collateral ankle ligament injuries were studied. Response to a questionnaire provided a 94% subjective evaluation at a mean of 9.5 years after surgery; 97% of patients were satisfied with the surgical result. Clinical examination, stress radiography, and biomechanical gait analysis studies were performed on 39 patients at four years or more after surgery (mean, 9.6 years). In 14% of those with ligament repair and 41% of those with reconstructive procedures, mean residual talar tilt with stress testing was 3.2° and 5.2°, respectively. Gait studies did not demonstrate a consistent abnormal gait pattern, even with side slope walking, and did not correlate with the talar tilt values. There was no significant measurable difference between the results of repair and reconstruction. Thus, most severe Grade III sprains can be managed nonoperatively, and if late residual instability occurs, a reconstructive procedure can be offered with confidence that the result will be equivalent subjectively and roughly comparable objectively to that of the immediate repair.
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M3 - Article
C2 - 3928221
AN - SCOPUS:0022413756
VL - NO. 198
SP - 110
EP - 117
JO - Clinical Orthopaedics and Related Research
JF - Clinical Orthopaedics and Related Research
SN - 0009-921X
ER -