References

1. Southmayd W Hoffman M: Sports Health: The Complete Book of Athletic Injuries. Quick Fox, 1981.

2. Barber FA, Sutker AN: Iliotibial band syndrome. Sports Med 1992;14: 144-148.

3. James SL: Running injuries to the knee. J AAOS 1995;3:309-318.

4. Alexander IJ: The Foot: Examination and Diagnosis. New York, Churchill Livingstone, 1997.

5. Sammarco GS: Foot and Ankle Manual. Baltimore, Williams & Wilkins, 1998.

6. Brodsky W: Outpatient diagnosis and care of the diabetic foot. Instruct Course Lect 1993;42:121-139.

7. Brostrom L: Sprained ankles: III Clinical observations in recent ligament ruptures. Acta Chir Scand 1965;130:560-569.

CHAPTER 66

Ankle Ligament Injury and Instability

Jeffrey D. Willers and Robert B. Anderson

In This Chapter

Acute lateral ankle sprain Chronic ligamentous instability Nonoperative management Surgery—lateral ankle reconstruction Modified Brostrom Modified Brostrom-split Evans Chrisman-Snook

Ankle sprains are the most common sports-related and recreational injury, representing an estimated 40% of all athletic injuries.1 Ankle sprains comprise an especially significant percentage of injuries in selective sports: 45% to 53% of all basketball injuries, 21% to 31% of soccer injuries, and 10% to 15% of football injuries that result in time lost.2,3 Jackson et al4 likely reported the truest incidence of ankle injuries in an athletic population in a study of U.S. Military Academy cadets. This study found that approximately one third of all cadets will sustain an ankle injury requiring medical treatment during their 4-year term at the Academy.

The vast majority (approximately 75%) of ankle sprains involve injury to the lateral ligament complex. The medial ligaments, however, are infrequently injured with eversion injuries. These medial injuries are rarely isolated injuries but instead usually occur in conjunction with lateral ankle injury or frac-ture.5 The anterior portion of the deltoid ligament is most frequently injured. An in-depth discussion of medial ligament injury and instability is beyond the scope of this chapter; thus, we focus on lateral ligament injury and instability.

Although most ankle sprains do heal with conservative treatment, it has been estimated in multiple studies that long-term sequelae do occur in a significant percentage of patients (up to 50%).6-9 Chronic instability has been reported to occur in 20% to 42% of patients with acute ankle sprains.10,11

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Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

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