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Chirurgia Del Piede 2005 September;29(3):137-44


language: Italian

Ligamentous rconstructione withan inferior extensor retinaculum flap in hindfoor insufficiency syndrome

Parino E., Acquaro P.


An ankle joint sprain of a certain entity may be the cause of the hindfoot insufficiency syndrome defined in consideration of its aspect of chronic laxity, correlated to the loss of the ligamentous passive stability, and of that of instability in relationship instead to the loss of the active stability due to miotendinous pathology, of the I or II motoneuron, or to damage of the proprioceptive system (the latter one of particular interest in this work). In literature the difference between laxity and instability is not always clear since most of the Authors write about mechanical ankle instability (resulting from mechanical laxity or from damage to the pericapsular soft tissues) and functional ankle instability (that is the subjective feeling of yelding of the ankle that occurs due to a proprioceptive deficit resulting from post-traumatic partial deafferentation of the ankle joint). Among the various surgical techniques described in literature the technique of ligamentous reconstruction and augmentation with an inferior extensor retinaculum flap as described by Brostrom-Gould generally gives good results. It consists in the repair of the anterior talofibular ligament and its augmentation utilising the lateral flap of the inferior extensor retinaculum (described as a contention formation, that acts as a pulley of reflection for the extendor tendons, maintaining them in contact with the frontal planes of the ankle joint). The objective of this work is to put into evidence through a retrospective study on patients affected by chronic insufficiency of the hindfoot, the possibility that the inferior extensor retinaculum may play an important proprioceptive role in contributing to improve the postoperative results in such patients. Indications and contraindications of the Brostrom-Gould procedure are also mentioned.

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