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Ankle and syndesmosis instability: consensus and controversies

Ankle sprains are mainly benign lesions, but if not well addressed can evolve into permanent disability. A non-treated lateral, syndesmotic or medial ankle instability can evolve into ankle osteoarthritis. For this reason, diagnosis and treatment of these entities is of extreme importance. In genera...

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Autores principales: Corte-Real, Nuno, Caetano, João
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Editorial Society of Bone and Joint Surgery 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8246108/
https://www.ncbi.nlm.nih.gov/pubmed/34267932
http://dx.doi.org/10.1302/2058-5241.6.210017
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author Corte-Real, Nuno
Caetano, João
author_facet Corte-Real, Nuno
Caetano, João
author_sort Corte-Real, Nuno
collection PubMed
description Ankle sprains are mainly benign lesions, but if not well addressed can evolve into permanent disability. A non-treated lateral, syndesmotic or medial ankle instability can evolve into ankle osteoarthritis. For this reason, diagnosis and treatment of these entities is of extreme importance. In general, acute instabilities undergo conservative treatment, while chronic instabilities are better addressed with surgical treatment. It is important to identify which acute instabilities are better treated with early surgical treatment. Syndesmosis injuries are frequently overlooked and represent a cause for persistent pain in ankle sprains. Unstable syndesmotic lesions are always managed by surgery. Non-treated deltoid ligament ruptures can evolve into a progressive valgus deformity of the hindfoot, due to its links with the spring ligament complex. This concept would give new importance to the diagnosis and treatment of acute medial ligament lesions. Multi-ligament lesions are usually unstable and are better treated with early surgery. A high suspicion rate is required, especially for combined syndesmotic and medial lesions or lateral and medial lesions. Ankle arthroscopy is a powerful tool for both diagnostic and treatment purposes. It is becoming mandatory in the management of ankle instabilities and multiple arthroscopic lateral/syndesmotic/medial repair techniques are emerging. Cite this article: EFORT Open Rev 2021;6:420-431. DOI: 10.1302/2058-5241.6.210017
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spelling pubmed-82461082021-07-14 Ankle and syndesmosis instability: consensus and controversies Corte-Real, Nuno Caetano, João EFORT Open Rev Instructional Lecture: Foot & Ankle Ankle sprains are mainly benign lesions, but if not well addressed can evolve into permanent disability. A non-treated lateral, syndesmotic or medial ankle instability can evolve into ankle osteoarthritis. For this reason, diagnosis and treatment of these entities is of extreme importance. In general, acute instabilities undergo conservative treatment, while chronic instabilities are better addressed with surgical treatment. It is important to identify which acute instabilities are better treated with early surgical treatment. Syndesmosis injuries are frequently overlooked and represent a cause for persistent pain in ankle sprains. Unstable syndesmotic lesions are always managed by surgery. Non-treated deltoid ligament ruptures can evolve into a progressive valgus deformity of the hindfoot, due to its links with the spring ligament complex. This concept would give new importance to the diagnosis and treatment of acute medial ligament lesions. Multi-ligament lesions are usually unstable and are better treated with early surgery. A high suspicion rate is required, especially for combined syndesmotic and medial lesions or lateral and medial lesions. Ankle arthroscopy is a powerful tool for both diagnostic and treatment purposes. It is becoming mandatory in the management of ankle instabilities and multiple arthroscopic lateral/syndesmotic/medial repair techniques are emerging. Cite this article: EFORT Open Rev 2021;6:420-431. DOI: 10.1302/2058-5241.6.210017 British Editorial Society of Bone and Joint Surgery 2021-06-28 /pmc/articles/PMC8246108/ /pubmed/34267932 http://dx.doi.org/10.1302/2058-5241.6.210017 Text en © 2021 The author(s) https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
spellingShingle Instructional Lecture: Foot & Ankle
Corte-Real, Nuno
Caetano, João
Ankle and syndesmosis instability: consensus and controversies
title Ankle and syndesmosis instability: consensus and controversies
title_full Ankle and syndesmosis instability: consensus and controversies
title_fullStr Ankle and syndesmosis instability: consensus and controversies
title_full_unstemmed Ankle and syndesmosis instability: consensus and controversies
title_short Ankle and syndesmosis instability: consensus and controversies
title_sort ankle and syndesmosis instability: consensus and controversies
topic Instructional Lecture: Foot & Ankle
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8246108/
https://www.ncbi.nlm.nih.gov/pubmed/34267932
http://dx.doi.org/10.1302/2058-5241.6.210017
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