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Ankle instability

N Harrasser, K Eichelberg, F Pohlig, H Waizy, A Toepfer, R von Eisenhart-Rothe
Because of their frequency, ankle sprains are of major clinical and economic importance. The simple sprain with uneventful healing has to be distinguished from the potentially complicated sprain which is at risk of transition to chronic ankle instability. Conservative treatment is indicated for the acute, simple ankle sprain without accompanying injuries and also in cases of chronic instability. If conservative treatment fails, good results can be achieved by anatomic ligament reconstruction of the lateral ankle ligaments...
October 13, 2016: Der Orthopäde
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Gwendolyn Vuurberg, Lana Kluit, C Niek van Dijk
PURPOSE: To develop a translated Dutch version of the Cumberland Ankle Instability Tool (CAIT) and test its psychometric properties in a Dutch population with foot and ankle complaints. METHODS: The CAIT was translated into the Dutch language using a forward-backward translation design. Of the 130 subsequent patients visiting the outpatient clinic for foot and ankle complaints who were asked to fill out a questionnaire containing the CAIT, the Foot and Ankle Outcome Score (FAOS), and the numeric rating scale (NRS) pain, 98 completed the questionnaire...
October 6, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Tun Hing Lui
The open anatomic repair of the anterior talofibular and calcaneofibular ligaments (modified Brostrom procedure) is widely accepted as the standard surgical stabilization procedure for lateral ankle instability that does not respond to conservative measures. Arthroscopic Brostrom procedures with a suture anchor have been reported to achieve both anatomic repair of the lateral ankle ligaments and management of the associated intra-articular lesions. However, the complication rates are higher than open Brostom procedures...
August 2016: Arthroscopy Techniques
A Rosen, J Ko, C Brown
Chronic ankle instability is a common pathological consequence of ankle sprains. However, screening tools which assess self-reported dysfunction offer little insight into clinical factors which may be useful to improve deficits. The purpose of this study was to identify factors that contribute most to self-reported dysfunction. 93 individuals completed the Cumberland Ankle Instability Tool (CAIT), active range of motion, dynamic postural stability assessments, and an arthrometer inversion stress test to assess lateral ankle laxity and stiffness...
October 5, 2016: International Journal of Sports Medicine
R Lopes, C Decante, L Geffroy, K Brulefert, T Noailles
Anatomical reconstruction of the lateral ankle ligaments has become a pivotal component of the treatment strategy for chronic ankle instability. The recently described arthroscopic version of this procedure is indispensable to ensure that concomitant lesions are appropriately managed, yet remains technically demanding. Here, we describe a simplified variant involving percutaneous creation of the calcaneal tunnel for the distal attachment of the calcaneo-fibular ligament. The rationale for this technical stratagem was provided by a preliminary cadaver study that demonstrated a correlation between the lateral malleolus and the distal footprint of the calcaneo-fibular ligament...
September 27, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Charlotte Apps, Thorsten Sterzing, Thomas O'Brien, Mark Lake
Unstable shoes (US) continually perturb gait which can train the lower limb musculature, but muscle co-contraction and potential joint stiffness strategies are not well understood. A shoe with a randomly perturbing midsole (IM) may enhance these adaptations. This study compares ankle and knee joint stiffness, and ankle muscle co-contraction during walking and running in US, IM and a control shoe in 18 healthy females. Ground reaction forces, three-dimensional kinematics and electromyography of the gastrocnemius medialis and tibialis anterior were recorded...
September 20, 2016: Journal of Electromyography and Kinesiology
Thomas O Clanton, Brady T Williams, Jonathon D Backus, Grant J Dornan, Daniel J Liechti, Scott R Whitlow, Adriana J Saroki, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Biomechanical data and contributions to ankle joint stability have been previously reported for the individual distal tibiofibular ligaments. These results have not yet been validated based on recent anatomic descriptions or using current biomechanical testing devices. METHODS: Eight matched-pair, lower leg specimens were tested using a dynamic, biaxial testing machine. The proximal tibiofibular joint and the medial and lateral ankle ligaments were left intact...
September 28, 2016: Foot & Ankle International
Juliette Ropars, Mathieu Lempereur, Sylvain Brochard, Carole Vuillerot, Vincent Tiffreau, Jean-Marie Cuisset, Yann Péréon, Fabien Leboeuf, Raphaël Gross, Ludovic Delporte, Yannick Delpierre
OBJECTIVE: The aim of this prospective study was to investigate changes in muscle activity during gait in children with Duchenne muscular Dystrophy (DMD). MATERIALS/PATIENTS AND METHODS: Dynamic surface electromyography recordings (EMGs) of 16 children with DMD and pathological gait were compared with those of 15 control children. The activity of the rectus femoris (RF), vastus lateralis (VL), medial hamstrings (HS), tibialis anterior (TA) and gastrocnemius soleus (GAS) muscles was recorded and analyzed quantitatively and qualitatively...
September 2016: Annals of Physical and Rehabilitation Medicine
S Y Lee, S-S Kwon, M S Park, M K Chung, K B Kim, S Koo, K M Lee
This study aimed to investigate the relationship between bone morphology and injured ligaments on imaging studies and laxity on ankle stress radiographs in patients with lateral ankle instability. In total, 115 patients who had undergone ankle MRI, ankle radiography, and stress radiography were included. Distal tibial articular surface angle, bimalleolar tilt, medial and lateral malleolar relative length, medial malleolar slip angle, anterior inclination of the tibia, and fibular position were measured on ankle radiographs...
September 27, 2016: International Journal of Sports Medicine
Ewout S Veltman, Ernst Ja Steller, Philippe Wittich, Jort Keizer
A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis requiring arthrodesis and chronic subtalar instability. Negative prognostic factors include lateral and complicated dislocations, total talar extrusions, and associated fractures. A literature search was performed to identify studies describing outcome after lateral subtalar joint dislocation...
September 18, 2016: World Journal of Orthopedics
Jennifer Baldwin, Marnee McKay, Claire Hiller, Elizabeth J Nightingale, Niamh Moloney, Joshua Burns
OBJECTIVE: To provide reference data for the Cumberland Ankle Instability Tool (CAIT) and investigate the prevalence and correlates of perceived ankle instability in a large healthy population. DESIGN: Cross-sectional observational study. SETTING: University laboratory. PARTICIPANTS: Self-reported healthy individuals (n=900; age range 8-101 years, stratified by age and gender) from the 1000 Norms Project. INTERVENTIONS: Not applicable...
September 22, 2016: Archives of Physical Medicine and Rehabilitation
Alison S Attenborough, Peter J Sinclair, Tristan Sharp, Andrew Greene, Max Stuelcken, Richard M Smith, Claire E Hiller
OBJECTIVES: Ankle sprains account for a large percentage of injuries sustained in netball. The identification of risk factors for ankle sprain is the preliminary action required to inform future prevention strategies. DESIGN: Prospective study. PARTICIPANTS: Ninety-four netball players from club and inter-district teams. METHODS: Preseason data were collected for; vertical jump height, perceived ankle instability, sprain history, arthrometry inversion-eversion angles, star excursion balance test reach distances, the number of foot lifts during unilateral stance and demi-pointe balance test results...
June 29, 2016: Physical Therapy in Sport
Terry L Grindstaff, Nadyne Dolan, Sam K Morton
OBJECTIVES: To determine differences in ankle dorsiflexion range of motion (ROM) between three groups of individuals with chronic ankle instability (CAI) based on Lateral Step Down Test quality of movement. The secondary purpose was to quantify the relationship between ankle dorsiflexion ROM and Lateral Step Down Test scores. DESIGN: Descriptive laboratory study. SETTING: University research laboratory. PARTICIPANTS: Fifty-nine participants with CAI...
July 29, 2016: Physical Therapy in Sport
Tarang Kumar Jain, Clayton N Wauneka, Wen Liu
BACKGROUND: Balance training has been shown to be effective in preventing ankle sprain recurrences in subjects with chronic ankle instability (CAI) but the biomechanical pathways underlying the clinical outcomes are still unknown. This study was conducted to determine if a 4-week balance training intervention can alter the mechanical characteristics in ankles with CAI. METHODS: Twenty-two recreationally active subjects with unilateral CAI were randomized to either a control (n = 11, 35...
2016: International Journal of Sports and Exercise Medicine
Guilherme S Nunes, Marcos de Noronha
OBJECTIVES: To investigate the impact different ways to define reference balance can have when analysing time to stabilization (TTS). Secondarily, to investigate the difference in TTS between people with chronic ankle instability (CAI) and healthy controls. DESIGN: Cross-sectional study. SETTING: Laboratory. PARTICIPANTS: Fifty recreational athletes (25 CAI, 25 controls). MAIN OUTCOME MEASURES: TTS of the center of pressure (CoP) after maximal single-leg vertical jump using as reference method the single-leg stance, pre-jump period, and post-jump period; and the CoP variability during the reference methods...
August 1, 2016: Physical Therapy in Sport
James M Cottom, Joseph S Baker, Phillip E Richardson
Lateral ankle sprains are a common injury that typically respond well to nonoperative therapy. When nonoperative therapy fails and patients develop chronic lateral ankle instability, they become candidates for surgical repair. The present study examined 45 consecutive patients (45 ankles) with chronic lateral ankle instability who underwent arthroscopic Broström repair using a double-row suture anchor construct. The 45 patients (27 females and 18 males) were followed up for a mean of 14 (range 12 to 20) months...
September 13, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kyeongtak Song, Christopher J Burcal, Jay Hertel, Erik A Wikstrom
PURPOSE: The underlying cause of balance impairments in chronic ankle instability (CAI) patients remains unknown, but an altered use of sensory information has been hypothesized as a potential cause. The purpose of this systematic review with meta-analysis was to determine whether CAI patients use somatosensory information to the same extent as uninjured controls during static single limb stance. METHODS: We searched PubMed, CINAHL, SPORTDiscus, and Scopus databases from origin to March 2016 using the combination of key words, including postural control, postural stability, single limb stance, single leg stance, single leg balance, single limb balance, and time to boundary (TTB)...
October 2016: Medicine and Science in Sports and Exercise
Anat V Lubetzky, Robert Price, Sarah W McCoy
Functional ankle instability is associated with decreased ankle muscle function. Compliant surfaces and eyes-closed training are commonly used for rehabilitation and prevention of ankle sprains. Brief Achilles tendon vibration is commonly used in the study of postural control. To test the level of activation of tibialis anterior (TIB) and fibularis longus (FIB), bilateral Achilles tendon vibration was applied for the middle 20 s in a series of 60-s trials, when 10 healthy young adults and 10 adults with history of repeated ankle sprains were standing bipedal: on floor, on memory foam, or on a Both Sides Up (BOSU) ball, with eyes open, and on floor and foam with eyes closed...
July 2016: Journal of Bodywork and Movement Therapies
Taegyu Kim, Eunkuk Kim, Hokyung Choi
OBJECTIVE: To determine whether a neuromuscular rehabilitation program can improve postural stability, and ankle evertor strength, and to examine the temporal changes and persistence of the rehabilitation effects in athletes with chronic ankle instability (CAI). DESIGN: A total of 21 national women's field hockey players participated in this study (CAI, n = 12; control, n = 9). Main outcome measures included isokinetic ankle evertor strength (peak torque, PT; total work, TW) at 30°/s, 60°/s, 90°/s and 120°/s, mediolateral stability index (MSI), and dynamic stability test (TCT)...
August 24, 2016: Journal of Sport Rehabilitation
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