Abstract

An evaluation under narcosis of joint slackness was carried out using functional radiographies at the Orthopaedics and Traumatology Division of Lecco Hospital from January 1979 to December 1986 in patients who had suffered serious tibiotarsal distorsions. 150 cases were examined in all, of which 101 were subjected to peroneo-tarsal capsulo-ligamentous reconstruction; 70 of the latter were patients who engaged in sport at competitive level (amateurs and semi-professionals). The lesions were verified by objective and forced varo-equine and anterior astragalic drawer radiographic examination, bilaterally, for the purpose of identifying possible congenital slackness. Only cases presenting a laterally open tibio-astragalic angle of more than 20 degrees associated with an astragalic drawer greater than 5 mm were subjected to capsulo-ligamentorrhaphy. As for the seriousness of the lesion, a proportional relationship was noted between the extent of the change in joint relations in the stress-films and the extent of the capsulo-ligamentous lesion. Reconstruction was carried out with a slow reabsorption stitch and plaster cast for 45 days, of which the first 25 non-weight-bearing. 80 of operated sports patients were reviewed. The injured resumed their sport on average 30 days after removal of the cast. Complete functional recovery was noted with resumption of competitive activity in almost all cases. In the less satisfactory results arthralgia was noted on overloading and slight rigidity of the tibiotarsal and subastragalic. Verf.-Referat