Foot and Ankle Instability A Clinical Guide to Diagnosis and Surgical Management

This book comprehensively discusses the basic and practical aspects of foot and ankle surgery applied to all pathologies resulting from instabilities of these joints, a condition that remains underestimated. Uniquely, it not only addresses injuries to the lateral ankle ligaments, but also examines injuries to the deltoid-spring ligament complex, the syndesmotic and chopart joint ligaments, as well as peritalar instability – all pathologies that have often been neglected in the past.

For each type of instability, it describes the anatomical basics and the biomechanical features, allowing readers to understand the injury pattern, the subsequent symptoms and clinical findings. Further, it offers guidance on selecting the most appropriate imaging tool for diagnosis and planning surgical reconstruction. Written by world-renowned pioneers in the field, and featuring a wealth of high-quality, intraoperative pictures, the book guides readers step-by-step through the latest, innovative technical surgical solutions for each condition.

With its consistent structure, from the basics to the solution, its problem-oriented approach as well as its meticulously selected iconography, this book is a must-read for all orthopedic surgeons with an interest in foot and ankle surgery whishing to explore this promising field. Further, it is a valuable resource for residents, researchers and physiotherapists wishing to gain insights into foot and ankle instability and reconstructive surgery.

I Lateral ankle instability.- 1 Anatomy of lateral ligaments of the ankle.- 2 Biomechanics of lateral ankle instability.- 3. Rotational instability.- 4. Conclusions and clinical implications.- 5. Injury pattern of lateral ankle ligaments.- 6. History and clinical presentation.- 7. Imaging.- 8. Arthroscopy.- 9. Conservative treatment and rehabilitation.- 10. Surgical management of lateral ankle instability.- 11. Results.- 12. Complications.- 13. Conclusions and future evolution.- II Lateral ankle instability including Chopart joint.- 14. Anatomy of Chopart joint ligaments.- 15 Biomechanics of Chopart joint.- 16 Injuries to the midtarsal joints.- 17. History and clinical presentation.- 18 Imaging.- 19. Treatment.- 20 Results.- 21. Complications.- 22. Conclusions.- III The unstable syndesmosis.- 23. Anatomy of syndesmosis.- 24 Biomechanics of syndesmotic instability.- 25. Conclusions and clinical implications.- 26. Injury mechanism.- 27.  History and clinical findings.- 28. Imaging.- 29. Arthroscopy.- 30. Conservative treatment and rehabilitation.- 31. Surgical management.-  32. Results.- 33. Complications.- 34. Conclusions.- IV Medial ankle instability (Deltoid-Spring ligament complex).- 35. Anatomy of medial ligaments of the ankle.- 36  Biomechanics of medial ankle instability.- 37. Conclusions and clinical implications.- 38. Injury pattern of medial ankle ligament.- 39.Injury mechanism.- 40. Clinical findings.- 41. Imaging.- 42. Arthroscopy.- 43. Conservative treatment and rehabilitation.- 44. Surgical management of medial ankle instability.- 45. Results.- 46. Complications.- 46. Conclusions and future evolution.- V Deltoid ligament injuries in ankle fractures.-  47. Trauma mechanism.- 48.  Diagnosis.- 49. Imaging.- 50. Arthroscopy.- 51. Treatment.- 52. Results.- 53. Complications.- 54. Conclusions.- VI Peritalar instability.- 55. Anatomy of peritalar joints.- 56. Anatomy of peritalar ligaments.- 57.Joint axis and motion.- 58. Biomechanics of peritalar instability.- 59. Conclusions and clinical implications.- 60. History and clinical presentation.- 61. Imaging.- 62. Arthroscopy.- 63. Classification of peritalar instability.- 64. Treatment of peritalar instability.- 65. Results.- 66. Complications.- 67. Conclusions and future evolution.

Beat Hintermann is Chairman of the Clinic for Orthopaedics and Traumatology at Kantonsspital Baselland, Switzerland and Associate Professor at the University of Basel. After his residency program, he completed a research fellowship in Biomechanics at the University of Calgary, Canada, and two fellowships: one in Asia and the USA, and one in the United Kingdom. In 2019, he founded the Center of Excellence for Foot and Ankle Surgery, which he has since chaired. During his tenure, new and innovative techniques and procedures have been introduced, such as ankle arthroscopy, correcting osteotomies and arthrodeses of the hindfoot complex and total ankle replacement. He concepted the H3 ankle and was a co-conceptor of the H2 ankle. He is author of over 240 peer-reviewed articles and 5 medical textbooks related to reconstructive surgery of the ankle and hindfoot complex. He has received numerous awards for his clinical and biomechanical research. In 2017, he was appointed as Visiting Professor at Ruijin University of Shanghai, China. He is regularly a faculty member at international foot and ankle meetings and organizer of practical instructional courses both in Switzerland and abroad.

Roxa Ruiz is a senior attending foot and ankle surgeon at the Center of Excellence for Foot and Ankle Surgery at Kantonsspital Baselland (Switzerland). She gained her medical degree and specialized in orthopedic trauma at the University in Lima, Peru. In 1998, she joined the Central Military Hospital of Lima, first as a senior resident, thereafter, as a Senior Attending Surgeon, she has served as the Head of the War Service Unit, one of the two units in the Orthopaedic Trauma Department there. In 2003, she made a fellowship at the Institute of Foot and Ankle at the Harvorview Medical Center in Seattle, USA, and in 2008, a fellowship in Baltimore, USA. In 2011, she spent 3 months at the Kantonsspital Liestal and then founded the Chapter for Foot and Ankle Surgery in the Peruvian Orthopaedic and Trauma Society, for which she also served as the first president. In 2014, she became a Guest Professor at the Postgrad Unit of the Mayor University of San Marcos in Lima. She is regularly a faculty member international foot and ankle meetings. She is author of numerous scientific papers and book chapters and co-conceptor of the H2 ankle prosthesis.