Chronic Ankle and Subtalar Joint Instability in the Athlete

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Presentation transcript:

Chronic Ankle and Subtalar Joint Instability in the Athlete Matthew J. Hentges, BA, Michael S. Lee, DPM Clinics in Podiatric Medicine and Surgery Volume 28, Issue 1, Pages 87-104 (January 2011) DOI: 10.1016/j.cpm.2010.10.001 Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 1 The Telos apparatus used for talar tilt examination. (From Lee MS, Hofbauer MH. Evaluation and management of lateral ankle injuries. Clin Podiatr Med Surg 1999;16:659–78; with permission.) Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 2 Anterior drawer test with the Telos apparatus showing significant anterior subluxation of the talus in the ankle joint. (From Lee MS, Hofbauer MH. Evaluation and management of lateral ankle injuries. Clin Podiatr Med Surg 1999;16:659–78; with permission.) Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 3 Manual stress inversion for talar tilt showing mechanical instability. (From Lee MS, Hofbauer MH. Evaluation and management of lateral ankle injuries. Clin Podiatr Med Surg 1999;16:659–78; with permission.) Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 4 (A) Curvilinear incision for Broström-Gould repair. (B) Linear incision for Broström-Gould stabilization. Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 5 Exposure of the anterior margin of the distal fibula. Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 6 Insertion of 2 corkscrew anchors in the distal fibula used to attach the distal cuff of tissue. Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 7 Vest-over-pants repair, demonstrating placement of all sutures before tying off each throw. Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 8 Incorporation of the inferior extensor retinaculum into the repair (Gould modification). Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 9 Incision approach for Chrisman-Snook. Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 10 Peroneal tendon graft. Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 11 Brevis through fibula. Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 12 Brevis into calcaneus. Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 13 Mortise (A) and lateral (B) ankle views demonstrating placement and orientation of interference screws used for a semitendinosus allograft. Clinics in Podiatric Medicine and Surgery 2011 28, 87-104DOI: (10.1016/j.cpm.2010.10.001) Copyright © 2011 Elsevier Inc. Terms and Conditions