Abstract des Autors

The authors examine herewith the main stabilizing elements of the ankle according to their function (i.e. tibio tarsal stabilizers, subastragalar stabilizers, "malleolar clamp stabilizer" and "mixed" stabilizers, that is to say, the ones that stabilize at the same time the tibio tarsal and underastragaloid areas). They confirm that, during the acute phase of complex lesions, it is sometimes difficult to reach the exact diagnosis as far as the entity and location of the lesion are concerned, unless some specific examinations are performed, which are not always advised or suggested because of high costs, long waiting lists and the invasive nature of some of them (i.e. MNR, arthrography, tests which require anesthesia) therefore, in case of doubt (i.e. is the lesion affecting one or more ligaments? Is the tibio tarsal involved and/or the subastragalar too?), they prefer to follow a conservative therapy (i.e. immobilization followed by physiokinesitherapy). They found out that such treatment, in the majority of the cases, allows for the total recovery of the athlete in shorter times compared with the cases treated with surgical solutions. Only 20% of the athletes treated with conservative therapy, have shown signs of instability six months after the date of the trauma. For this group then, after the proper tests (Dynamic test, MNR) needed to reach the correct diagnosis, a surgical reconstruction has been performed, and more specifically: for AAP lesions: Castaing procedure; for CP lesions: Vidal procedure; for Clamp lesions: screen insertion. We haven't found, as yet, "pure" subastragalar lesions. In "mixed" lesions we performed Vidal's procedure. Thirty-nine of the 42 patients operated resumed sport activity at previous levels. Verf.-Referat