{"title":"Surgical intervention yields superior results over conservative management in calcaneal-side calcaneofibular ligament rupture.","authors":"Jin Su Kim, Chul Hyun Park","doi":"10.1016/j.fas.2025.05.014","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To the best of our knowledge, no study has investigated complete calcaneal-side calcaneofibular ligament (CFL) rupture. This study was performed to compare the clinical and radiographic results of conservative and surgical treatments for acute ankle sprains with complete calcaneal-side CFL rupture.</p><p><strong>Methods: </strong>This study included 36 patients diagnosed with acute ankle sprain and complete calcaneal-side CFL rupture. The first 14 patients were treated conservatively (group C), and the remaining 22 underwent surgery (group S). Clinical results between the two groups were compared regarding their scores on the Cumberland Ankle Instability Tool (CAIT) and patient satisfaction with the treatment. Radiographic results were evaluated for the rupture status of the CFL on preoperative magnetic resonance imaging and stability of the ankle joint using a stress radiographs with Telos and manual anterior drawer test.</p><p><strong>Results: </strong>At the last follow-up, the mean CAIT score was significantly higher in group S than in group C (P < 0.001). The treatment dissatisfaction rate was significantly higher in group C (P = 0.003). In all cases, the proximal migration distance of the ruptured CFL significantly correlated with the incidence of Stener's-like lesions, in which the distal stump of the CFL was displaced over the peroneal tendons (R=0.721, P < 0.001). Stress radiographs showed no significant difference in postoperative instability between groups. In the manual anterior drawer test at the last follow-up, the proportion of stable ankles was significantly higher in group S than in group C (P = 0.02).</p><p><strong>Conclusion: </strong>Surgical treatment could improve clinical results and satisfaction in patients with acute ankle sprains and complete calcaneal-side CFL rupture.</p><p><strong>Level of evidence: </strong>III, Retrospective cohort study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot and Ankle Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.fas.2025.05.014","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: To the best of our knowledge, no study has investigated complete calcaneal-side calcaneofibular ligament (CFL) rupture. This study was performed to compare the clinical and radiographic results of conservative and surgical treatments for acute ankle sprains with complete calcaneal-side CFL rupture.
Methods: This study included 36 patients diagnosed with acute ankle sprain and complete calcaneal-side CFL rupture. The first 14 patients were treated conservatively (group C), and the remaining 22 underwent surgery (group S). Clinical results between the two groups were compared regarding their scores on the Cumberland Ankle Instability Tool (CAIT) and patient satisfaction with the treatment. Radiographic results were evaluated for the rupture status of the CFL on preoperative magnetic resonance imaging and stability of the ankle joint using a stress radiographs with Telos and manual anterior drawer test.
Results: At the last follow-up, the mean CAIT score was significantly higher in group S than in group C (P < 0.001). The treatment dissatisfaction rate was significantly higher in group C (P = 0.003). In all cases, the proximal migration distance of the ruptured CFL significantly correlated with the incidence of Stener's-like lesions, in which the distal stump of the CFL was displaced over the peroneal tendons (R=0.721, P < 0.001). Stress radiographs showed no significant difference in postoperative instability between groups. In the manual anterior drawer test at the last follow-up, the proportion of stable ankles was significantly higher in group S than in group C (P = 0.02).
Conclusion: Surgical treatment could improve clinical results and satisfaction in patients with acute ankle sprains and complete calcaneal-side CFL rupture.
Level of evidence: III, Retrospective cohort study.
期刊介绍：
Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society.
The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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