Condition Articles-Ankle Instability PDF

Ankle Instability PDF
Pdf Summary
Ankle instability is a condition that occurs after an ankle sprain and involves recurrent sprains, persistent pain, and a feeling of the ankle giving way. It is caused by various factors such as static alignment, muscle weakness, poor proprioception, and ligamentous injury. If left untreated, ankle instability can lead to decreased function, decreased quality of life, arthritis, and chronic pain.<br /><br />The ankle joint is composed of the tibia, fibula, and talus, and stability is maintained through the surrounding ligaments. The lateral ligament complex includes the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL), while medial stability is provided by the deltoid ligament.<br /><br />Ankle stability relies on osseous, ligamentous, and tendinous structures. Malalignment of the ankle can contribute to instability, but primary stability occurs at the ligament level. The ATFL is the most commonly injured ligament, while the CFL and PTFL also play a role in stability.<br /><br />Ankle instability arises from the same mechanism as ankle sprains. Mechanical factors such as ligament laxity, synovial changes, and degenerative changes can contribute to instability, as well as functional factors such as altered proprioception, neuromuscular control, and strength deficits.<br /><br />Patients with ankle instability may present with persistent pain, recurrent sprains, and a feeling of giving way. Diagnosis is typically made through a thorough physical exam that includes assessing overall alignment, testing for tenderness and range of motion, and performing provocative tests.<br /><br />Imaging studies such as weightbearing radiographs and stress radiographs can be used to assess mechanical stability. Ultrasound and MRI can also be used to assess soft tissue structures and chondral injury.<br /><br />Treatment for ankle instability begins with non-operative measures such as strength training and proprioception instruction. Bracing may be used in conjunction with rehabilitation. If instability persists, surgical intervention may be necessary. Anatomic repair and tenodesis stabilization are the two main categories of surgical treatment options.<br /><br />Overall, ankle instability can be a debilitating condition, but with a proper understanding of the pathology and treatment options, patient satisfaction can be achieved.
Keywords
ankle instability
recurrent sprains
persistent pain
ankle giving way
static alignment
muscle weakness
poor proprioception
ligamentous injury
decreased function
decreased quality of life