eMedicine Specialties > Orthopedic Surgery > Foot & Ankle

Recurrent Ankle Sprains: Multimedia

Author: Joseph R Bozzelle, Jr, MD, Director, Rehabilitation Services, Crowley Rehabilitation Hospital, Doctors Hospital of Opelousas, Southwest Medical Center
Coauthor(s): Stephen Kishner, MD, MHA, Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans; James Monroe Laborde, MD, MS, Clinical Assistant Professor, Department of Orthopedics, Tulane Medical School; Adjunct Assistant Professor, Department of Biomedical Engineering, Tulane University; Adjunct Assistant Professor, Department of Physical Medicine and Rehabilitation, Louisiana State University Medical School; Consulting Staff, Department of Orthopedic Surgery, Louisiana State University Health Sciences Center
Contributor Information and Disclosures

Updated: Feb 15, 2008

Multimedia

Anatomy of the lateral ankle ligamentous complex ...Media file 1: Anatomy of the lateral ankle ligamentous complex and related structures.
Anatomy of the lateral ankle ligamentous complex ...

Anatomy of the lateral ankle ligamentous complex and related structures.

Medial ankle view showing the ligamentous anatomy...Media file 2: Medial ankle view showing the ligamentous anatomy of the deltoid ligament and related structures.
Medial ankle view showing the ligamentous anatomy...

Medial ankle view showing the ligamentous anatomy of the deltoid ligament and related structures.

Posterior view of the ligaments of the ankle.Media file 3: Posterior view of the ligaments of the ankle.
Posterior view of the ligaments of the ankle.

Posterior view of the ligaments of the ankle.

More on Recurrent Ankle Sprains

Overview: Recurrent Ankle Sprains
Workup: Recurrent Ankle Sprains
Treatment: Recurrent Ankle Sprains
Follow-up: Recurrent Ankle Sprains
Multimedia: Recurrent Ankle Sprains
References

References

  1. Hertel J. Functional instability following lateral ankle sprain. Sports Med. May 2000;29(5):361-71. [Medline].

  2. Ekstrand J, Gillquist J. The avoidability of soccer injuries. Int J Sports Med. May 1983;4(2):124-8. [Medline].

  3. Valderrabano V, Wiewiorski M, Frigg A, Hintermann B, Leumann A. [Chronic ankle instability] [German]. Unfallchirurg. Aug 2007;110(8):691-9; quiz 700. [Medline].

  4. Hubbard TJ, Kramer LC, Denegar CR, Hertel J. Contributing factors to chronic ankle instability. Foot Ankle Int. Mar 2007;28(3):343-54. [Medline].

  5. Staples OS. Ruptures of the fibular collateral ligaments of the ankle. Result study of immediate surgical treatment. J Bone Joint Surg Am. Jan 1975;57(1):101-7. [Medline][Full Text].

  6. Brand RL, Black HM, Cox JS. The natural history of inadequately treated ankle sprain. Am J Sports Med. Nov-Dec 1977;5(6):248-9. [Medline].

  7. Larsen E. Tendon transfer for lateral ankle and subtalar joint instability. Acta Orthop Scand. Apr 1988;59(2):168-72. [Medline].

  8. Karlsson J, Eriksson BI, Renström PA. Subtalar ankle instability. A review. Sports Med. Nov 1997;24(5):337-46. [Medline].

  9. Mann RA. Major surgical procedures for disorders of the ankle, tarsus, and midtarsus. In: Mann RA, ed. Surgery of the Foot. 5th ed. St Louis, Mo: Mosby-Year Book, Inc; 1986:283-304.

  10. Hopkinson WJ, St Pierre P, Ryan JB, Wheeler JH. Syndesmosis sprains of the ankle. Foot Ankle. Jun 1990;10(6):325-30. [Medline].

  11. Smith RW, Reischl SF. Treatment of ankle sprains in young athletes. Am J Sports Med. Nov-Dec 1986;14(6):465-71. [Medline].

  12. Bosien WR, Staples OS, Russell SW. Residual disability following acute ankle sprains. J Bone Joint Surg Am. Dec 1955;37-A(6):1237-43. [Medline][Full Text].

  13. Freeman MA, Dean MR, Hanham IW. The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br. Nov 1965;47(4):678-85. [Medline][Full Text].

  14. Freeman MAR, Wyke BD. An experimental study of articular neurology. J Bone Joint Surg. 1967;49B:185.

  15. O'Donoghue DH. Treatment of Injuries to Athletes. 2nd ed. Philadelphia, Pa: WB Saunders Co; 1970.

  16. Pisani G. Chronic laxity of the subtalar joint. Orthopedics. May 1996;19(5):431-7. [Medline].

  17. Attarian DE, McCrackin HJ, DeVito DP, McElhaney JH, Garrett WE Jr. Biomechanical characteristics of human ankle ligaments. Foot Ankle. Oct 1985;6(2):54-8. [Medline].

  18. Ogilvie-Harris DJ, Reed SC, Hedman TP. Disruption of the ankle syndesmosis: biomechanical study of the ligamentous restraints. Arthroscopy. Oct 1994;10(5):558-60. [Medline].

  19. Rasmussen O. Stability of the ankle joint. Analysis of the function and traumatology of the ankle ligaments. Acta Orthop Scand Suppl. 1985;211:1-75. [Medline].

  20. Harper MC. The lateral ligamentous support of the subtalar joint. Foot Ankle. Jun 1991;11(6):354-8. [Medline].

  21. Kjaersgaard-Andersen P, Wethelund JO, Helmig P, Søballe K. Stabilizing effect of the tibiocalcaneal fascicle of the deltoid ligament on hindfoot joint movements: an experimental study. Foot Ankle. Aug 1989;10(1):30-5. [Medline].

  22. Kjaersgaard-Andersen P, Wethelund JO, Helmig P, Søballe K. The stabilizing effect of the ligamentous structures in the sinus and canalis tarsi on movements in the hindfoot. An experimental study. Am J Sports Med. Sep-Oct 1988;16(5):512-6. [Medline].

  23. Cass JR, Morrey BF, Katoh Y, Chao EY. Ankle instability: comparison of primary repair and delayed reconstruction after long-term follow-up study. Clin Orthop Relat Res. Sep 1985;198:110-7. [Medline].

  24. Trouilloud P, Dia A, Grammont P, Gelle MC, Autissier JM. [Variations in the calcaneo-fibular ligament (lig. calcaneofibulare). Application to the kinematics of the ankle] [French]. Bull Assoc Anat (Nancy). Mar 1988;72(216):31-5. [Medline].

  25. Anderson KJ, LeCocq JF, Clayton ML. Athletic injury to the fibular collateral ligament of the ankle. Clin Orthop. 1962;23:146-61. [Medline].

  26. Safran MR, Benedetti RS, Bartolozzi AR 3rd, Mandelbaum BR. Lateral ankle sprains: a comprehensive review: part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis. Med Sci Sports Exerc. Jul 1999;31(7 suppl):S429-37. [Medline].

  27. Chrisman OD, Snook GA. Reconstruction of lateral ligament tears of the ankle. An experimental study and clinical evaluation of seven patients treated by a new modification of the Elmslie procedure. J Bone Joint Surg Am. Jul 1969;51(5):904-12. [Medline][Full Text].

  28. Breitenseher MJ. [Injury of the ankle joint ligaments] [German]. Radiologe. Mar 2007;47(3):216-23. [Medline].

  29. Richie DH Jr. Effects of foot orthoses on patients with chronic ankle instability. J Am Podiatr Med Assoc. Jan-Feb 2007;97(1):19-30. [Medline].

  30. Safran MR, Zachazewski JE, Benedetti RS, Bartolozzi AR 3rd, Mandelbaum R. Lateral ankle sprains: a comprehensive review part 2: treatment and rehabilitation with an emphasis on the athlete. Med Sci Sports Exerc. Jul 1999;31(7 suppl):S438-47. [Medline].

  31. Broström L. Sprained ankles. VI. Surgical treatment of "chronic" ligament ruptures. Acta Chir Scand. Nov 1966;132(5):551-65. [Medline].

  32. Gould N, Seligson D, Gassman J. Early and late repair of lateral ligament of the ankle. Foot Ankle. Sep 1980;1(2):84-9. [Medline].

  33. Coughlin M, Mann R, eds. Surgery of the Foot and Ankle. 7th ed. St Louis, Mo: Mosby-Year Book, Inc; 1999:1114-53.

  34. Wolin I, Glassman F, Sideman S, Levinthal DH. Internal derangement of the talofibular component of the ankle. Surg Gynecol Obstet. Aug 1950;91(2):193-200. [Medline].

  35. Bassett FH 3rd, Gates HS 3rd, Billys JB, Morris HB, Nikolaou PK. Talar impingement by the anteroinferior tibiofibular ligament. A cause of chronic pain in the ankle after inversion sprain. J Bone Joint Surg Am. Jan 1990;72(1):55-9. [Medline][Full Text].

  36. Ross SE, Arnold BL, Blackburn JT, Brown CN, Guskiewicz KM. Enhanced balance associated with coordination training with stochastic resonance stimulation in subjects with functional ankle instability: an experimental trial. J Neuroeng Rehabil. Dec 17 2007;4(1):47. [Medline][Full Text].

  37. Ross SE. Noise-enhanced postural stability in subjects with functional ankle instability. Br J Sports Med. Oct 2007;41(10):656-9; discussion 659. [Medline].

  38. Hale SA, Hertel J, Olmsted-Kramer LC. The effect of a 4-week comprehensive rehabilitation program on postural control and lower extremity function in individuals with chronic ankle instability. J Orthop Sports Phys Ther. Jun 2007;37(6):303-11. [Medline].

  39. Edwards GS Jr, DeLee JC. Ankle diastasis without fracture. Foot Ankle. May-Jun 1984;4(6):305-12. [Medline].

  40. Katznelson A, Lin E, Militiano J. Ruptures of the ligaments about the tibio-fibular syndesmosis. Injury. Nov 1983;15(3):170-2. [Medline].

  41. Hassan AH. Treatment of anterolateral impingements of the ankle joint by arthroscopy. Knee Surg Sports Traumatol Arthrosc. Sep 2007;15(9):1150-4. [Medline].

  42. Ogilvie-Harris DJ, Reed SC. Disruption of the ankle syndesmosis: diagnosis and treatment by arthroscopic surgery. Arthroscopy. Oct 1994;10(5):561-8. [Medline].

  43. Mabit C, Pécout C, Arnaud JP. [Ligamentoplasty using the peroneus tertius in the correction of lateral laxity of the ankle. Surgical technique] [French]. Rev Chir Orthop Reparatrice Appar Mot. 1996;82(1):70-5. [Medline].

  44. Sammarco GJ, Carrasquillo HA. Surgical revision after failed lateral ankle reconstruction. Foot Ankle Int. Dec 1995;16(12):748-53. [Medline].

  45. Ozkan T, Tunçer S, Oztürk K, Aydin A, Ozkan S. [Surgical restoration of drop foot deformity with tibialis posterior tendon transfer] [Turkish, English]. Acta Orthop Traumatol Turc. 2007;41(4):259-65. [Medline][Full Text].

  46. Brody PJ, Grumbine N. Peroneus tertius reconstruction for flexible clawtoes associated with cavus deformity: a preliminary report. J Foot Surg. Sep-Oct 1984;23(5):357-61. [Medline].

  47. Anderson KJ, LeCocq JF, LeCocq EA. Recurrent anterior subluxation of the ankle joint; a report of two cases and an experimental study. J Bone Joint Surg Am. Oct 1952;34 A(4):853-60. [Medline][Full Text].

  48. Clayton ML, Weir GJ Jr. Experimental investigations of ligamentous healing. Am J Surg. Sep 1959;98:373-8. [Medline].

  49. Frigg A, Magerkurth O, Valderrabano V, Ledermann HP, Hintermann B. The effect of osseous ankle configuration on chronic ankle instability. Br J Sports Med. Jul 2007;41(7):420-4. [Medline].

  50. Karlsson J, Eriksson BI, Renström P. Subtalar instability of the foot. A review and results after surgical treatment. Scand J Med Sci Sports. Aug 1998;8(4):191-7. [Medline].

  51. Korkala O, Rusanen M, Grönblad M. Healing of experimental ligament rupture: findings by scanning electron microscopy. Arch Orthop Trauma Surg. 1984;102(3):179-82. [Medline].

  52. Le Gall F, Carling C, Reilly T. Injuries in young elite female soccer players: an 8-season prospective study. Am J Sports Med. Feb 2008;36(2):276-84. [Medline].

  53. Porter EB, Young CC, Niedfeldt MW, Gottschlich LM. Sport-specific injuries and medical problems of figure skaters. WMJ. Sep 2007;106(6):330-4. [Medline].

  54. Rosenfeld P. Acute and chronic peroneal tendon dislocations. Foot Ankle Clin. Dec 2007;12(4):643-57, vii. [Medline].

Further Reading

Keywords

recurrent ankle instability, chronic ankle sprain, chronic ankle instability, subtalar instability, functional ankle instability, chronic medial ligament instability, mechanical ankle instability

Contributor Information and Disclosures

Author

Joseph R Bozzelle, Jr, MD, Director, Rehabilitation Services, Crowley Rehabilitation Hospital, Doctors Hospital of Opelousas, Southwest Medical Center
Joseph R Bozzelle, Jr, MD is a member of the following medical societies: Louisiana State Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Stephen Kishner, MD, MHA, Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans
Stephen Kishner, MD, MHA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation and American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

James Monroe Laborde, MD, MS, Clinical Assistant Professor, Department of Orthopedics, Tulane Medical School; Adjunct Assistant Professor, Department of Biomedical Engineering, Tulane University; Adjunct Assistant Professor, Department of Physical Medicine and Rehabilitation, Louisiana State University Medical School; Consulting Staff, Department of Orthopedic Surgery, Louisiana State University Health Sciences Center
James Monroe Laborde, MD, MS is a member of the following medical societies: American Academy of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

Medical Editor

John S Early, MD, Foot/Ankle Specialist, Texas Orthopaedic Associates, LLP; Co-Director, North Texas Foot and Ankle Fellowship Baylor University Medical Center
John S Early, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Foot and Ankle Society, Orthopaedic Trauma Association, and Texas Medical Association
Disclosure: Zimmer Inc Consulting fee Consulting; Smith Nephew Consulting fee Consulting; AO North America Honoraria Speaking and teaching; Osteotech Consulting fee Consulting; Stryker Consulting fee Consulting

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Shepard R Hurwitz, MD, Executive Director, American Board of Orthopaedic Surgery
Shepard R Hurwitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for the Advancement of Science, American College of Rheumatology, American College of Sports Medicine, American College of Surgeons, American Diabetes Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Association for the Advancement of Automotive Medicine, Eastern Orthopaedic Association, Orthopaedic Research Society, Orthopaedic Trauma Association, and Southern Orthopaedic Association
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Jason H Calhoun, MD, FACS, Frank J Kloenne Chair in Orthopedic Surgery, Professor and Chair, Department of Orthopedics, The Ohio State University Medical Center
Jason H Calhoun, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Diabetes Association, American Medical Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Missouri State Medical Association, Musculoskeletal Infection Society, Southern Medical Association, Southern Orthopaedic Association, Texas Medical Association, and Texas Orthopaedic Association
Disclosure: Nothing to disclose.

 
 
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