[Surgical treatment of chronic ankle joint instability--many variations in German clinics. Analysis of a 1994 German survey].

A questionnaire was mailed to 400 orthopaedic department chairpersons in Germany listed by the "Deutsche Gesellschaft für Unfallchirurgie" to evaluate the current surgical approach to chronic ankle instability. The aim of the survey was to analyze and to classify the reconstruction method of the individual institution. Questionnaires were returned from 267 hospitals (66.7%). The number of ligament reconstructions performed at individual institutions ranged from 1 to over 100 (mean 17.5). The most frequently used procedures of primary choice for reconstruction of the ligaments are: periosteal flaps (45.3%), anatomical repair (23.6%), different tenodeses (20.6%), and free anatomical implants of autologous or exogenous material (10.5%). 50% of the participants use reconstructions in which the injured ligament is repaired secondarily without augmentation or with periosteal flaps. The remaining part of the German surgeons prefers tenodeses or various other procedures. It is interesting to note that there is a high number of different procedures not namely known in the literature which are considered as individual modifications. With better knowledge of the function of the single ligament and general exposure of the ligaments for simple overlap and direct suture, the rate of primary non-anatomical reconstructions may be decreased in the future.