Treatment algorithm of chronic ankle and subtalar instability. 1997

H Thermann, and H Zwipp, and H Tscherne
Trauma Department, Hannover Medical School, Germany.

From 1981 to 1984, 131 reconstructive procedures and 113 Evans tenodesis procedures (1972-1984) were performed for patients with chronic instability of the ankle joint. From 1981 to 1985, 42 Christman/Snook procedures were performed for patients with isolated or combined subtalar instability. Reevaluation was conducted for 223 patients (102 reconstructive procedures, 87 Evans tenodesis procedures, and 34 Christman/Snook tenodesis procedures). The follow-up protocol comprised standard and stress radiograms, subjective patient evaluation, and objective functional data. No patient in either treatment group had clinically important ankle instability. Patients who had undergone the Evans tenodesis had a 3.3 degrees mean less talar tilt than did patients treated with reconstructive procedure. Of 87 patients who underwent Evans tenodesis, 33 had a mean supination deficit of 7.5 degrees. According to the +/- 100 points classification, 90% of the patients in both groups achieved good or excellent results. For subtalar instability, the Christman/Snook techniques resulted in a mean supination deficit of 7.2 degrees in 20 patients. Of 34 patients, 31 were rated good or excellent.

UI MeSH Term Description Entries
D007593 Joint Instability Lack of stability of a joint or joint prosthesis. Hypermobility, Joint,Instability, Joint,Laxity, Joint,Hypermobilities, Joint,Instabilities, Joint,Joint Hypermobilities,Joint Hypermobility,Joint Instabilities,Joint Laxities,Joint Laxity,Laxities, Joint
D008023 Ligaments, Articular Fibrous cords of CONNECTIVE TISSUE that attach bones to each other and hold together the many types of joints in the body. Articular ligaments are strong, elastic, and allow movement in only specific directions, depending on the individual joint. Articular Ligament,Articular Ligaments,Ligament, Articular
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000465 Algorithms A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. Algorithm
D000843 Ankle Joint The joint that is formed by the inferior articular and malleolar articular surfaces of the TIBIA; the malleolar articular surface of the FIBULA; and the medial malleolar, lateral malleolar, and superior surfaces of the TALUS. Ankle Syndesmosis,Articulatio talocruralis,Distal Tibiofibular Joint,Inferior Tibiofibular Joint,Talocrural Joint,Tibiofibular Ankle Syndesmosis,Tibiofibular Syndesmosis,Ankle Joints,Ankle Syndesmoses,Ankle Syndesmosis, Tibiofibular,Distal Tibiofibular Joints,Inferior Tibiofibular Joints,Joint, Ankle,Joints, Ankle,Syndesmosis, Ankle,Talocrural Joints,Tibiofibular Ankle Syndesmoses,Tibiofibular Joint, Distal,Tibiofibular Syndesmoses
D013380 Subtalar Joint Formed by the articulation of the talus with the calcaneus. Talocalcaneal Joint,Joint, Subtalar,Joint, Talocalcaneal,Joints, Subtalar,Joints, Talocalcaneal,Subtalar Joints,Talocalcaneal Joints
D013524 Surgical Flaps Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region. Island Flap,Island Flaps,Flap, Surgical,Flaps, Surgical,Pedicled Flap,Surgical Flap,Flap, Island,Flap, Pedicled,Flaps, Island,Flaps, Pedicled,Pedicled Flaps
D013710 Tendons Fibrous bands or cords of CONNECTIVE TISSUE at the ends of SKELETAL MUSCLE FIBERS that serve to attach the MUSCLES to bones and other structures. Endotenon,Epotenon,Tendons, Para-Articular,Tendons, Paraarticular,Endotenons,Epotenons,Para-Articular Tendon,Para-Articular Tendons,Paraarticular Tendon,Paraarticular Tendons,Tendon,Tendon, Para-Articular,Tendon, Paraarticular,Tendons, Para Articular

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