Transcript Chronic Lateral Ankle Instability of a Collegiate Soccer Player

CHRONIC LATERAL ANKLE INSTABILITY
OF A COLLEGIATE SOCCER PLAYER
NICHOLAS BAUMANN, ATS; SHAWN D. FELTON, EdD, ATC, LAT; BRITTANY LORING, ATC, LAT
FLORIDA GULF COAST UNIVERSITY, COLLEGE OF HEALTH PROFESSIONS AND SOCIAL WORK, FORT MYERS, FL 33965
Abstract
This case reviews a collegiate soccer
player who developed chronic lateral
ankle instability after a serious ankle
sprain and attempted non-surgical
rehabilitation that was unsuccessful in
regaining her ankle stability. As a result,
she underwent the modified Brostrom
ankle procedure utilizing suture anchors,
ultimately regaining stability to the
injured ankle.
Purpose
For 80% of patients, an ankle sprain is an
isolated event and after appropriate treatment
will not recur. For the other 20% the injury is
part of a pattern of chronic lateral ankle
instability. This case highlights the clinical
presentation and treatment of chronic lateral
ankle instability including non-operative
treatment, proper physical examination when
an athlete first presents with such a
complaint, surgical intervention, and postoperative rehabilitation.
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Background
Treatment
20-year old female
Sophomore collegiate soccer player
Previous severe ankle sprain
Extensive unsuccessful post-injury
rehabilitation
The Brostrom ankle procedure utilizing two
Corkscrew suture anchors inserted at the
origins of the anterior talofibular and
calcaneofibular ligaments on the anterior
part of the lateral malleolus.
16-18 weeks of post-operative
rehabilitation
•Week 3: progressive weightbearing
•Weeks 4-6: gentle ROM
•Week 6: strengthening & proprioceptive
training
•Week 8: plyometric training
•Week 12: straight running & functional
activities
•Week 16: cutting & sport specific drills
Clinical Evaluation
•Stress radiographs: 15° talar tilt angle
•Stress radiographs: 11mm anterior talar
translation
•Pre-op Karlsson score of 45
•Subjectively did not “trust” ankle
•Had sensation of ankle “giving way” during
athletic activity
Conclusion
This case report presents the clinical
presentation and surgical intervention used
to treat chronic lateral ankle instability.
Recognition of its symptoms and timely
referral to a competent surgeon can
eliminate repetitive injury and loss of
playing time for a competitive athlete.