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Ankle microinstability: arthroscopic findings reveal four types of lesion to the anterior talofibular ligament's superior fascicle
- Source :
- Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 29(4)
- Publication Year :
- 2020
-
Abstract
- ATFL’s superior fascicle injury has been considered to be the underlying cause in cases of ankle microinstability. As its clinical diagnosis can be difficult, arthroscopic examination may be the only objective diagnostic tool. The purpose of this study was to determine what types of injuries to the ATFL’s superior fascicle are associated with ankle microinstability, and to provide the reader with an arthroscopic classification of the types of microinstability affecting the ankle. Ankle arthroscopy video records obtained during a four-year period from 232 patients with the diagnosis of ankle microinstability were reviewed. The characteristics of the ATFL’s superior fascicle injury were identified, described and recorded along with any concomitant intra-articular pathology. Four different injury patterns were consistently seen affecting the ATFL’s superior fascicle. These ranged from ligament attenuation associated with loss of tension (type I), through to partial detachment (type II) or total detachment (type III) from the fibula. Finally, a total or partial resorption of the ATFL’s superior fascicle (type IV) was also observed. There was a statistically significant association between the type of injury identified and the rate of intra-articular pathology observed arthroscopically. Equally, the higher the type in the classification, the higher the rate of loose bodies, lateral talar OCD, deltoid “open book” tears, and anterior soft-tissue formation. Different types of ATFL’s superior fascicle injury can be observed in patients with ankle microinstability, ranging from ligament attenuation associated with a loss of tension (8.2%) to different degrees of partial (69.1%) and total (16.8%) ligament detachment from the fibula, or ligament remnant resorption (5.9%). As the type of injury progresses along with the proposed classification, the rate of intra-articular injuries also increases. The clinical relevance of this study is that a morphological ATFL’s superior fascicle tear is recognized in patients with the diagnosis of ankle microinstability. IV.
- Subjects :
- Adult
Joint Instability
Male
medicine.medical_specialty
Adolescent
Deltoid curve
03 medical and health sciences
Arthroscopy
Young Adult
0302 clinical medicine
Medicine
Humans
Orthopedics and Sports Medicine
Ankle Injuries
Fibula
030222 orthopedics
medicine.diagnostic_test
business.industry
Anterior talofibular ligament
030229 sport sciences
Anatomy
Fascicle
Middle Aged
medicine.anatomical_structure
Orthopedic surgery
Ligament
Surgery
Female
Ankle
business
Lateral Ligament, Ankle
Subjects
Details
- ISSN :
- 14337347
- Volume :
- 29
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
- Accession number :
- edsair.doi.dedup.....2b841ce332d69803581e87e4494612f0