ABSTRACT
Purpose@#Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. @*Materials and Methods@#A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. @*Results@#Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. @*Conclusion@#This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.
ABSTRACT
PURPOSE: We compared the results of total ankle arthroplasty in patients with preoperative varus deformity of more than 20degrees with those of patients with varus deformity less than 20degrees. MATERIALS AND METHODS: From January 2005 to January 2013, 9 ankles with preoperative varus deformity of more than 20degrees (varus group) and 31 ankles with varus deformity less than 20degrees (control group) underwent total ankle arthroplasty. Clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score, and radiographic results were assessed using tibiotalar varus angle in standing anteroposterior radiographs taken preoperatively and at the last follow-up. RESULTS: The mean duration of clinical follow-up was 42.8 months (14~60 months). The AOFAS score was improved by a mean 47.0 points in the varus group and 37.6 points in the control group. Statistically significant difference was observed between the two groups (p=0.041). Tibiotalar varus angle measured at the last follow-up radiograph was 2.5degrees in the varus group and 1.0degrees in the control group and the difference was not statistically significant (p=0.820). CONCLUSION: Satisfactory clinical and radiographic results can be achieved in patients with varus deformity more than 20degrees by precise bone resection and soft tissue release.