Article

The varus ankle and instability.

Foot and Ankle Surgery, Department of Orthopaedics, University of Zurich, Balgrist, Forchstrasse 340, 8008 Zurich, Switzerland.
Foot and ankle clinics 03/2012; 17(1):57-82. DOI: 10.1016/j.fcl.2011.11.003
Source: PubMed

ABSTRACT Varus ankle associated with instability can be simple or complex. Multiple underlying diseases may contribute to this complex pathologic entity. These conditions should be recognized when attempting proper decision-making. Treatment options range from conservative measures to surgical reconstruction. Whereas conservative treatment might be a possible approach for patients with simple varus ankle instability, more complex instabilities require extensive surgical reconstructions. However, adequate diagnostic workup and accurate analysis of varus ankle instability provide a base for the successful treatment outcome.

1 Bookmark
 · 
471 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Spastic foot and ankle deformities can occur from various causes and have profound effects on individuals and society. Presentations can vary clinically and a thorough clinical evaluation, potentially with a dynamic electromyogram, is essential to selecting the most appropriate treatment. Nonoperative treatments, such as orthotics, casting, oral medications, and nerve blocks, can be effective but surgery is indicated if they are no longer effective. Of the various operative procedures to treat this condition, split anterior tibialis tendon transfer and tendo Achilles lengthening are the most commonly performed. Multiple surgical options have been shown to be effective.
    Foot and ankle clinics 03/2014; 19(1):97-111.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Varus and valgus ankle deformities represent a challenge to the foot and ankle surgeons. The presence of degenerative changes of the tibiotalar joint articular surfaces introduces an additional layer of complexity. Reconstruction of such deformities requires a customized approach to each patient. Surgical intervention often requires joint-sparing realignment, arthroplasty, and/or arthrodesis, depending on the severity of deformity and the joint surface integrity. The ligamentous stability of the ankle plays an essential role in the preservation and optimization of function. This article reviews the role of deltoid and lateral ligament reconstruction in the treatment of varus and valgus ankle osteoarthritis.
    Foot and ankle clinics 09/2013; 18(3):517-27.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The subtle cavovarus foot (SCF) is a mild malalignment caused by either primary hindfoot varus or a plantarflexed first ray, resulting in a typical constellation of symptoms because of altered foot mechanics. Key clinical signs are a peek-a-boo heel and a positive Coleman block test. The cavovarus position places lateral ankle soft-tissue structures, such as the anterior talofibular ligament and the peroneal tendons, on stretch during normal gait. This can lead to common conditions such as lateral ankle instability, peroneal tendon tears, and stress fractures of the lateral metatarsals and cuboid. The gait cycle is altered because a greater proportion of time is spent with the transverse tarsal joints locked due to the overall varus foot position. In contradistinction to physiologic valgus at heel strike, which maintains the transverse tarsal joints unlocked and affords approximately 50% force dissipation, the increased rigidity of the foot causes a maldistribution of forces that leads to accelerated wear of the midfoot joints and increased stresses along the plantar fascia and the Achilles tendon insertion. Successful nonsurgical management requires correction of the biomechanical anomaly; surgical management of a subtle cavovarus foot typically is part of a comprehensive plan for correcting the symptoms and the malalignment.
    The Journal of the American Academy of Orthopaedic Surgeons 08/2014; 22(8):512-520. · 2.40 Impact Factor

Full-text

Download
158 Downloads
Available from
May 20, 2014