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Ankle Instability: General facts

Ankle Instability
  • Ankle sprains are the most common injury to the ankle
  • ~25% of ankle sprains turn into chronic ankle instability
    • Increased rates if inappropriate rehabilitation
  • Patients with chronic ankle instability report ankle giving out with everyday activities, pain on the outside of the ankle, and avoidance of doing some activities due to feelings of instability
  • If left untreated, ankle instability can lead to ankle arthritis
  • Diagnosis is made based on clinical examination and history; MRI is often obtained to evaluate for associated injuries

Lateral Ankle Ligament Anatomy

  • Three ligaments make up the lateral ankle ligament complex (ATFL, CFL, and PTFL)
  • ATFL is most commonly injured, followed by the CFL
  • The ligaments prevent the ankle from turning inwards
  • When injured, they generally heal but if not rehabbed appropriately, can heal in a stretched out position

Non-Operative Treatment Ankle Instability

  • Nonoperative treatment should be attempted on all patients with chronic instability
  • PT for minimum of 6-12 weeks
  • Activity modification
  • Lace-up ankle brace

Operative Treatment Ankle Instability

  • Surgery is recommended in patients who have continued pain and feelings of instability despite non-surgical treatment
  • Surgery tightens up the ligaments and reattaches them to the bone in the appropriate position
  • Lateral ligament repairs are often done at the same time as surgery on the peroneal tendons and ankle arthroscopy depending on the findings of MRI
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