[The periosteal flap augmentation technique in chronic lateral ankle instability].

[The periosteal flap augmentation technique in chronic lateral ankle instability]. Oper Orthop Traumatol. 2019 Apr 29;: Authors: Mittlmeier T, Rammelt S Abstract OBJECTIVE: Anatomic repair of the lateral ligament complex of the ankle joint and augmentation with an autologous pedicled periosteal flap of the distal fibula following identification and concomitant treatment of intra-articular pathologies. INDICATIONS: Symptomatic chronic mechanical lateral ankle instability. As a modular step in the treatment of osteochondral lesions in conjunction with lateral ankle instability. CONTRAINDICATIONS: Higher degree osteoarthritis of the ankle joint (>Kellgren/Lawrence 2 and 4 or Outerbridge 3 and 4) and/or hindfoot deformity; mechanical incompetence of both the fibulotalar anterior ligament and the fibulocalcaneal ligament preventing anatomical reinsertion; general risk factors. SURGICAL TECHNIQUE: Diagnostic arthroscopy for identification and treatment of intraarticular pathologies; verification and grading of ligamentous instability (medial, lateral, combined). Open exposure of the distal fibula and the ruptured components of the lateral ankle ligament complex. Anatomic reinsertion of the original ligaments and assessment of their mechanical competence. Apart from the situation in the juvenile patient with a thick periosteal layer a doubled and pedicled periosteal strip of the distal fibular periosteum will...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research