Anatomic reconstruction of the lateral ligaments of the ankle using a plantaris tendon graft

The purpose of this work was to present our technique of anatomic reconstru ction of the lateral ankle ligaments using a free plantaris tendon graft. B etween 1988 and 1997, 52 ankles (48 patients) were treated for chronic ankl e instability resisting to a training program of minimally 3 months. The av erage age was 28.6 years (16 to 46 years) at the time of surgery. There wer e 30 ankles in men and 22 ankles in females. 4 patients were treated on bot h ankles. 50 ankles were available far a follow-up investigation after a me an of 3.5 years (1 to 10 years). Based on the AOFAS-Hindfoot-Scale an avera ge score of 97.9 points (90 to 100 points) was found. The functional result was found to be excellent in 39 ankles (78 %), good in 9 ankles (18 %), fa ir in 2 ankles (4%), and poor in 0 ankle (0 %). Dorsi-/plantarflexion was n ot restricted in any ankle. Supination was slightly restricted in 2 ankles, but not increased in any ankle. High patient's satisfaction with respect t o the achieved stability was found in all but one ankle. No deterioration w ith time was observed in any case. The overall good and excellent results w ith this method may be explained by the strictly anatomic reconstruction th at did not alter the kinematics nor the mechanics of the ankle joint comple x. in addition the peroneal tendons were not weakened. We feel that this pr ocedure is a better alternative to other more complex ligament reconstructi ons, especially tenodesis operations by using the peroneal tendon.