Ankle Instability and Reconstruction

The lateral collateral complex is made up of the ATFL, CFL and PTFL. The ATFL is probably one of the most commonly injured ligaments in the human body, due to the relative weak nature of the ligament and anatomic position on the outside of the ankle joint. Along with the CFL they are poor resistors of inversion since the torque of the body over these small structures can easily overwhelm their ability to contain movement beyond a certain point. Consider this an 'evolutionary weak point.'  When inversion injuries occur, a square bone is turned or rotated inside of a square recess - not a good scenario. The shoulders of the ankle bone wedge the fibula outward, causing tension on the ligaments which will ultimately tear. In addition the cartilage and surrounding structures (capsule, tendons, and muscles) also sustain damage.  Surgical repair involves inventory of all of these structures, including the syndesmosis that holds the tibia and fibula together. In this episode I focused on the direct repair or augmentation of the most common situations. In the next episode I will dive into more detail on osteochondral defects, and later on the high ankle sprain and more occult injuries that are commonly missed even by astute practitioners.  The content of this podcast is for educational and informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.