Abstract: Introduction: Ankle sprains involving the anterior talo-fibular ligament are one of the commonest injuries encountered in the day to day orthopaedic practice. Routinely these chronic instabilities are also initially treated non-operatively. Surgical intervention is required if the conservative treatment fails or in individuals demanding rapid return to athletic activities. The commonly performed surgeries for these injuries involve reconstruction of Anterior Talo-fibular ligament. We are describing a non anatomic technique using Semitendinosus graft for the reconstruction of lateral structures, including anterior talo-fibular and calcaneo-fibular ligament.
Materials and Methods: A total of 6 patients who sustained trauma to their ankle more than 6 months prior to presentation in the form of an inversion injury came with complaints of pain and instability in the respective ankles. There was an increase in the lateral clear space with lateral tilt of talus on the radiograph. MRI scan showed loss of continuity of anterior talofibular ligament and bone marrow oedema in the dome of talus and anterior aspect of lower tibia. All patients were treated surgically using our technique.
Results: The mean FAOS significantly improved from 33.63 points to 81.96 and VAS showed a decrease from 7.8 to 4.3 in 6 months.
Conclusion: Our modification can enhance the lateral stability as two strands of the tendon control the inversion laxity. In this way our technique gives extra importance to the calcaneo-fibular ligament without reducing the strength of peroneus brevis muscle. At the same time we also ensure dynamic stability of the ankle by suturing the ATFL arm of the graft to peroneus brevis so that we recreate the normal gait mechanics. We found this study to give excellent results in subtalar instability and tibio-talar instability without any donor site morbidity.
