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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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, swelling and ecchymosis on the lateral ankle and heel side with marked laxity. Ankle instability Ankle instability is either mechanical or functional instability, or both. Mechanical instability may occur following certain anatomical defects
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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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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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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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, especially when significant soft tissue removal is needed ( 22 ). Complications may occur, such as ankle instability due to resection of ligaments around the ankle ( 44 ), pseudarthrosis, or intraoperative distal tibial fracture ( 31 ). The quality of bone
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develop long-lasting symptoms: feeling of ankle instability (‘giving way’), pain, swelling and recurrent sprains, ultimately resulting in functional limitations. 3 The proportion of patients who reported that they still experienced pain at 1-year
Ludwig Maximilian University Munich, Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Zentrum München (MUM), Marchionostraße, Munich, Germany
Justus Maximilian University Wuerzburg, König-Ludwig-Haus, Brettreichstraße, Würzburg, Germany
Paracelsus Medizinische Privatuniversität, Strubergasse, Salzburg, Austria
Working Group Clinical Tissue Regeneration of the German Society of Orthopaedics and Traumatology (DGOU), Berlin, Germany
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Ludwig Maximilian University Munich, Klinik für Orthopädie und Unfallchirurgie, Muskuloskelettales Zentrum München (MUM), Marchionostraße, Munich, Germany
Working Group Clinical Tissue Regeneration of the German Society of Orthopaedics and Traumatology (DGOU), Berlin, Germany
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Martin-Luther-University Halle-Wittenberg, Universitätsklinikum Halle (Saale), DOUW - Abteilung für Unfall- und Wiederherstellungschirurgie, Ernst-Grube-Straße, Halle, Germany
BG-Klinikum Bergmannstrost Halle, Halle, Saale, Germany
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with bone marrow stimulation (BMS) (microfracture, micro-drilling). The procedure can be performed arthroscopically. Takao et al. ( 54 ) analyzed 69 patients with ankle instability and grade 3 or 4 OLT (Pritsch classification modified by Takao). One
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metatarsals and fractures of the fifth metatarsal are common. Ankle instability, recurrent sprains and lateral pain are common presenting symptoms. This may be due to lateral overload caused by the hindfoot varus but may also be due to lax lateral ankle
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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
