Results of surgical treatment of patients with acute injuries of the lateral ligamentous apparatus of the ankle joint
Recently, there are many reports of restoration of anterior talofibular ligament and calcaneofibular ligament under arthroscopic control. The lack of analysis of the results, a small number of operated patients were the basis for the study. Objective: To determine the indications for restoration of the lateral part of the ankle joint by means of open techniques and under arthroscopic control. Methods: Results of treatment of 73 patients (41 male, 32 female, mean age 33 years) with fresh injuries of the lateral ligaments of the ankle joint were analyzed. In patients of the main group (34) we used arthroscopic techniques and in patients of control group (39) we used open ones. Results: Indications for restoration of the ligaments under arthroscopic control were developed. Significantly higher levels of pain according to VAS starting from the first day after surgery was found in cases of open procedures as opposed to arthroscopic ones. Range of motion in the ankle joint recovered almost fully in patients of the main group to the 14th day after the operation and in patients of the control group recovered to the 21nd day. At 6 weeks after open surgeries score according to Ankle-Hindfoot Scale AOFAS was veraciously lower than in cases of arthroscopic procedures. Excellent outcomes obtained in 17 patients (77.3 %) of the main group and 18 (62.1 %) of the control one, good — in 3 (13.6 %) and 6 (20.7 %), respectively. Proportion of positive results was significantly higher in the main group. Conclusion: In all patients with fresh injuries of the lateral ligaments of the ankle joint an arthroscopy should be performed for the diagnosis of concomitant intraarticular pathology and on its basis one should develop tactics of surgical treatment. Strict adherence to the indications for the restoration of the ligaments (open or under arthroscopic control) determines the long-term outcomes.
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