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Foot and Ankle: S. P. J. Muijs, P. D. S. Dijkstra, and C. F. A. Bos Clinical outcome after anatomical reconstruction of the lateral ankle ligaments using the Duquennoy technique in chronic lateral instability of the ankle: A LONG-TERM FOLLOW-UP STUDY J Bone Joint Surg Br 2008; 90-B: 50-56 [Abstract] [Full text] [PDF]

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No clear evidence for clinical outcome following the Duquennoy technique

Stephen J Lipscombe, Jordi Sanchez-Ballister   (9 June 2008)

No clear evidence for clinical outcome following the Duquennoy technique 9 June 2008
Stephen J Lipscombe, Orthopaedic SpR Whiston and St.Helen's hospitals, Jordi Sanchez-Ballister Send letter to journal: Re: No clear evidence for clinical outcome following the Duquennoy technique sjlipscombe{at}lycos.com Stephen J Lipscombe, et al.	Sir, We read this article with interest but we found some areas of concern. The methodology section does not state clearly the inclusion criteria used for this study; the population is not clearly specified. Eighty-five per cent of cases of ankle instability can be managed non-operatively with a period of ankle bracing and physiotherapy.1,2 The study does not mention which patients did and which patients did not have physiotherapy before surgery was undertaken. Secondly, there appears to be an absence of pre-operative scoring of the patients. Therefore, it was not possible to analyse post-operative improvement, for which only talar tilt and anterior drawer test were available as an assessment tool. In addition, these analyses were performed without radiographic screening and scored using an unvalidated clinical assessment system. The remainder of the assessments relied on post-operative scoring only and comparison with the contralateral ankle movements. Plain radiographs used to determine the progression of osteoarthritis deteriorated at final follow-up and correlate poorly with ankle function. Finally, a complication rate of 8.7% (two patients out of 23) could hardly be described as being very low. In conclusion, with the data and the results presented in this study there is not enough evidence to state that the Duquennoy technique is an effective method of improving ankle function in patients with chronic instability with a very low rate of complications. S.J. Lipscombe, Orthopaedic SpR, J. Sanchez-Ballister, Whiston and St. Helen's Hospitals, Merseyside, UK. 1. Karlsson J, Lansinger O. Chronic lateral instability of the ankle in athletes. Sports Med 1993;16:355-65. 2. Trevino SG, Davis P, Hecht PJ. Management of acute and chronic lateral ligament injuries of the ankle. Orthop Clin North Am 1994;25:1-16.