Abstract des Autors

Ankle ligament injuries are the most common injuries in sports and recreational activities and account for about 25% of the injuries that occur in running and jumping sports. 75% of all ankle injuries are ankle sprains, and 85% of these sprains are caused by an inversion trauma. Although most of these ligamentous ankle injuries can be treated successfully with physical rehabilitation and no operative treatment, 20% to 40% of patients with these injuries will go on to experience chronic instability and subsequent disability. Some of the reasons for these conflicting results may be attributed to a lack of respecting the biomechanics of the unstable ankle joint complex when operative treatment is carried out. There is, apparently, need for a better understanding of the function of the ligament structures, as well as their susceptibility to injury and resultant instability. The present studies have shown that there is not one single entity of ankle instability. Beside of the simple lateral instability, rotational instability was shown to be present in as high as 38%. The hallmarks of this disorder are a feeling of giving-way, pain on the medial gutter of the ankle, progressive plano-valgus deformity with or without forefoot abduction. The deformity can typically be corrected by posterior tibial (PT) muscle strength. Because the PT tendon becomes overloaded, tendonitis may develop with tenderness and swelling along the PT tendon, thus imitating PT tendon dysfunction. Careful clinical investigation and preoperative assessment by arthroscopy, are thought to have mostly contributed to the better understanding the pathologic process. We suppose that earlier recognition of this disorder might in addition help to improve the outcome in the near future. Verf.-Referat