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Nuno Corte-Real Department of Orthopaedics, Hospital de Cascais Dr. José de Almeida, Portugal

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João Caetano Department of Orthopaedics, Hospital de Cascais Dr. José de Almeida, Portugal

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Introduction Ankle instability is a clinical condition closely related with the traumatic event commonly known as ankle sprain, usually a supination trauma. This event is extremely frequent, being one of the top causes of Emergency Room visits

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Gema Chamorro-Moriana Department of Physiotherapy, Research Group “Area of Physiotherapy CTS-305”, University of Seville, Seville, Spain

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Veronica Perez-Cabezas Department of Nursing and Physiotherapy, Research Group MOVEIT (eMpOwering health by physical actiVity, Exercise and nutrition) CTS-1038, University of Cadiz, Cadiz, Spain

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Marisa Benitez-Lugo Department of Physiotherapy, Research Group “Area of Physiotherapy CTS-305”, University of Seville, Seville, Spain

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and sports, ankle sprains have the highest incidence ( 4 ). The lateral ligament complex is the most frequently injured ( 2 , 5 , 6 , 7 ), and injury to this complex represents up to 85% of all ankle sprains ( 8 ). Chronic ankle instability (CAI

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Omar A. Al-Mohrej King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia

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Nader S. Al-Kenani King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia

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instability. 4 Epidemiology Among all ankle injuries, ankle sprains are the most common and account for approximately 80%, 5 , 6 of which 77% are lateral sprains. 73% of lateral ankle sprains are due to rupture or tear of the ATFL. 7

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Mario Herrera-Pérez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
Department of Surgery, Universidad de La Laguna, Tenerife, Spain

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Victor Valderrabano Foot and Ankle Unit, Orthopaedic Department, Schmerzklinik, Basel, Switzerland
University of Basel, Basel, Switzerland

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Alexandre L Godoy-Santos Orthopaedic Department, Hospital Israelita, Sao Paulo, Brazil

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César de César Netto Director of the UIOWA Orthopedic Functional Imaging Research Laboratory (OFIRL), Iowa, USA
Department of Orthopedic and Rehabilitation, University of Iowa, Iowa, USA

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David González-Martín Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
Department of Surgery, Universidad de La Laguna, Tenerife, Spain

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Sergio Tejero Foot and Ankle Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
Department of Surgery, Universidad de Sevilla, Sevilla, Spain

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ligament instability, particularly those affecting the lateral collateral ankle ligament (which some authors call ligamentous ankle OA) ( Fig. 2 ) ( 8 , 9 ). Ankle instability increases the peak joint contact stresses of the ankle joint, resulting in

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Kinner Davda Department of Foot & Ankle Surgery, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK

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Karan Malhotra Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK

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Paul O’Donnell Department of Foot & Ankle Surgery, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK

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Dishan Singh Department of Foot & Ankle Surgery, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK

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Nicholas Cullen Department of Foot & Ankle Surgery, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK

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pathologies are frequently encountered in patients with chronic lateral ankle instability or cavovarus hindfoot alignment, and usually result from prolonged, repetitive athletic activities or ankle inversion injuries. The management of these conditions is

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Ulrike Wittig Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Gloria Hohenberger Department of Trauma, LKH Feldbach-Fürstenfeld, Feldbach, Austria

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Martin Ornig Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Reinhard Schuh Department of Orthopaedics, Protestant Hospital Vienna, Vienna, Austria

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Andreas Leithner Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Patrick Holweg Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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by immobilization in a brace ( 9 , 10 , 11 ). However, about 10 to 20% develop chronic lateral ankle instability (CLAI) and consequently require surgical ligament repair ( 12 , 13 ). The Broström technique as well as its modifications is considered

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Mario Herrera-Pérez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
School of Medicine, Universidad de La Laguna, Tenerife, Spain

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Pablo Martín-Vélez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain

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David González-Martín Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
School of Medicine, Universidad de La Laguna, Tenerife, Spain

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Miguel Domínguez-Meléndez Foot and Ankle Unit, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain

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Ahmed E Galhoum Specialty Doctor Trauma and Orthopaedics, George Eliot Hospital NHS Trust, Nuneaton, UK

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Victor Valderrabano Schmerzklinik, Basel, Switzerland
University of Basel, Basel, Switzerland

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Sergio Tejero Foot and Ankle Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
School of Medicine, Universidad de Sevilla, Sevilla, Spain

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( 25 ). Fracture stability The instability of the fracture has been considered an inclusion criterion in 6 of the 11 articles studied. Unstable ankle fractures are those which cannot be properly controlled using closed reduction and cast

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Fabian Krause Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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Helen Anwander Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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patients with OLT present ankle ligament laxity and 39% of patients with ankle instability present with an OLT ( 5 , 6 ). Subsequently, acute trauma and repetitive micro-traumata due to ankle instability and/or hindfoot malalignment seem to be a leading

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Andrea Angelini Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Ivan Bohacek Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Salata, Zagreb, Croatia

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Mihovil Plecko Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Salata, Zagreb, Croatia

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Carlo Biz Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Giulia Trovarelli Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Mariachiara Cerchiaro Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Giuseppe Di Rubbo Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Pietro Ruggieri Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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instability, valgus deformity, and degenerative changes ( 5 , 15 , 16 , 17 ). Resection of the distal fibula without reconstruction can result in functional deficits in the ankle joint, as the fibula plays an important role in ankle stability and movement

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J. Javier Masquijo Department of Pediatric Orthopaedics, Sanatorio Allende, Córdoba, Argentina

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Cristian Artigas Hospital Roberto del Rio, Santiago, Chile
Clínica Alemana, Santiago, Chile

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Julio de Pablos Advanced Bone Reconstruction Surgery, Hospital San Juan de Dios y Complejo Hospitalario de Navarra, Pamplona, Spain

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years old. Implant size is critical when deciding the time of surgery in younger patients, especially when the deformity to be treated is around smaller joints such as the ankle. Available implants on the market are as small as 12 mm plates and 16 mm

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