Instability of the Ankle

摘要

The aim of this paper is to suggest an in-depth approach for chronic ankle instability. The factors in stability and the joint kinematics of the ankle are reported. The pathomechanics of ligaments and associated lesions are developed. The working diagnosis is supported by clinical and imaging tools in order to locate precisely the numerous ligamentous injuries, to identify the predisposing factors such as the hindfoot morphology, and any lesions associated with chronicity: anterolateral impingement, fibular injury, osteochon-dral lesions of the talus dome and early osteoarthritis. The different therapeutic and medico-surgical options adapted to this diagnostic approach are identified, from conservative (reprograrnrning rehabilitation techniques) to surgical repair with augmentation of the torn ligaments, hindfoot malalignment correction, and any additional procedures focussed on associated lesions. The goal of this diagnostic and therapeutic approach is to stop the progression of instability and to prevent the occurrence of osteoarthritis.