TREATMENT ALGORITHM OF CHRONIC ANKLE AND SUBTALAR INSTABILITY

From 1981 to 1984, 131 reconstructive procedures and 113 Evans tenodes is procedures (1972-1984) were performed for patients with chronic ins tability of the ankle joint, From 1981 to 1985, 42 Christman/Snook pro cedures were performed for patients with isolated or combined subtalar instability, Reevaluation was conducted for 223 patients (102 reconst ructive procedures, 87 Evans tenodesis procedures, and 34 Christman/Sn ook tenodesis procedures). The follow-up protocol comprised standard a nd stress radiograms, subjective patient evaluation, and objective fun ctional data. No patient in either treatment group had clinically impo rtant ankle instability, Patients who had undergone the Evans tenodesi s had a 3.3 degrees mean less talar tilt than did patients treated wit h reconstructive procedure, Of 87 patients who underwent Evans tenodes is, 33 had a mean supination deficit of 7.5 degrees. According to the +/-100 points classification, 90% of the patients in both groups achie ved good or excellent results, For subtalar instability, the Christman /Snook techniques resulted in a mean supination deficit of 7.2 degrees in 20 patients, Of 34 patients, 31 were rated good or excellent.