[Relevance of predamage in fibulotalar ligament rupture. Clinical and histological studies].

In 31 patients with a recent rupture of the fibulotalar ligament, the aetiology and the significance of prior traumatization were investigated clinically and histologically. History. All the patients reported that they had twisted the injured foot either once or on a number of occasions. Only five patients were able to identify a concrete accident. Intraoperatively, the anterior fibulotalar ligament showed scarring in addition to fresh rupture. Histologically, excisional biopsies (EB) obtained during surgery, also revealed fresh lesions affecting the collagenous tissue as well as granulation and/or scar tissue of varying age. Pre-traumatization of the fibulotalar ligament occurs as a result of simple twisting of the foot. This apparently insignificant trauma leads to microlesions which although they induce reparative processes that can be demonstrated histologically, produce a relevant diminishment of the resistance of the ligament to rupture. Thus, ligament rupture can readily be explained by the interaction of prior traumatization and a violent force. In comparison, prior degenerative lesions have no relevance. In the individual case, therefore, in addition to prior history, the nature of any accident and intraoperative findings, a histological examination should also be performed for an epicritical assessment of the aetiopathogenesis.