Treatment Of Chronic Lateral Ankle Instability With ATLF And CFL Fibular Advancement: Surgical Technique And Clinical Outcome
Bibliographic record
Abstract
Objectives: To report the 2 to 5 year outcome of ATFL and CFL fibular advancement for the treatment of lateral ligament instability of the ankle. Methods: Fifty-five patients presenting with chronic lateral ankle instability who had failed non-operative management (bracing, taping, physiotherapy) underwent a lateral ligament fibular advancement between 2005 and 2008. In each case the ATLF and CFL were released from the fibula and advanced using two double loaded metallic suture anchors (3.5mm). The senior author DJOH) performed all the cases. Patients were allowed to full weight bear in a walking boot for 6 weeks after surgery. Patients were assessed pre-operatively and post-operatively using the Foot and Ankle Outcome Score (FAOS). Data were prospectively collected and retrospectively reviewed by an independent author. Results: Six patients (11%) were lost at follow-up, leaving a study group of 49 patients (23 male and 26 female). The mean patient age at the time of surgery was 25 years old (range, 18-37 years old), with a mean duration of symptoms of 1.8 years (range, 6 months - 5 years). The mean follow-up was 42 months (range, 24 - 60 months). Significant improvement was seen in the FAOS score from a mean value of 36 pre-op to 75.4 post-op (p<0.001). Pain subscale improved from 35 to 75 (p<0.001); symptoms from 29 to 77 (p=0.01); function from 45 to 77 (p<0.001); function in sports and recreation from 38 to 70 (p<0.001); foot and ankle related quality of life from 35 to 78 (p<0.001). The failure rate was 6%, with three patients complaining of residual instability secondary to re-tear. Two cases of superficial infections were seen. One patient complained of temporary nerve irritation and numbness. Conclusion: This study demonstrates that ATFL and CFL advancement with suture anchor fixation and early, protected weight bearing is an effective procedure for the treatment of chronic lateral ankle instability.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".