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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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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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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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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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rotational instability. Only a complete rupture of all three ligaments (AiTFL, IOL, and PiTFL) causes a multiplanar instability of the DTFJ and leads to a frank diastasis ( 9 ). The diagnosis and classification of two-ligament (AiTFL and IOL ruptures) and
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recently, arthroscopy has been promoted ( 7 ). However, arthroscopy is an invasive, highly demanding technique, and the definition of instability criteria is hindered due to considerable individual anatomical variations ( 11 ). The external rotation
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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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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
Department of Surgery, Universidad de La Laguna, Tenerife, Spain
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University of Basel, Basel, Switzerland
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Department of Orthopedic and Rehabilitation, University of Iowa, Iowa, USA
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Department of Surgery, Universidad de La Laguna, Tenerife, Spain
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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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- Fracture of the entire posterior process of the talus. Type 4: a severe form of fracture of either of the processes and associated instability or dislocation of the subtalar joint. Management The literature lacks a consensus on the optimum
