ACUTE REPAIR AND DELAYED RECONSTRUCTION FOR LATERAL ANKLE INSTABILITY- 20-YEAR FOLLOW-UP-STUDY

Objectives: To determine long-term results of patients who underwent p rimary ligament repair and delayed reconstruction for lateral ligament instability. Design: Retrospective. Setting: Outpatient clinic. Patie nts/Participants: Patients who had undergone acute repair or delayed r econstruction at this institution between 1958 and 1977, excluding pat ients who were deceased or who could not be located. Intervention: For ty-eight patients (fifty-three ankles) underwent twenty-two primary li gament repairs and thirty-one delayed reconstruction operations. Main Outcome Measurements: Clinical results graded with clinical scale and radiologic results based on stress radiographs and plain film radiogra phs. Results: At an average of twenty years after operation (range 12 to 33 years), patients were satisfied with forty-nine ankles, satisfie d with reservations with two ankles, and dissatisfied with two ankles. Clinical results after repair were excellent in twenty ankles, good i n one, fair in none, and poor in one. After reconstruction, the result s were excellent in twenty-one ankles, good in six, fair in one, and p oor in three. In the primary repair group, the mean talar tilt with st ress testing improved from 20.7 +/- 10.7 degrees before operation to 2 .8 +/- 3.0 degrees after operation. In the reconstruction group, the m ean talar tilt improved from 20.7 +/- 8.4 degrees before operation to 2.8 +/- 3.5 degrees after operation. Conclusions: Clinical and radiolo gic results were similar in the repair and reconstruction groups. The majority of severe (Grade III) ankle sprains may be treated nonoperati vely, but if residual instability occurs, late reconstruction should a chieve satisfactory results.