Reinforced Anatomical Reconstruction of the Anterior Talofibular Ligament in Chronic Anterolateral Instability Using a Periosteal Flap

Twenty-eight consecutive ankles with chronic severe lateral instability were treated by reinforced anatomic reconstruction using a periosteal flap from the lateral aspect of the fibula. At the followup after a median of 24 months, 86% had excellent or good functional results. This result compares favorably with other techniques. As the results after tenodesis appear to deteriorate with time, anatomic reconstruction is recommended. No complications were encountered. No statistical correlation was found between clinical and radiological versus functional instability at followup.