Skip to content

Patients › Ankle

全踝关节置换术

PDF Evidence Consent
Updated Sep 2026
Illustration: ankle

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

为何建议进行此手术

踝关节炎是指关节内部的平滑表面已磨损，导致骨与骨直接摩擦。它通常继发于踝部骨折或严重扭伤。其致残程度可与髋关节炎相当。对于大多数患有此长期问题的患者，我们首先采取非手术治疗，如改变活动方式、物理治疗和支具固定，并在这些措施未能提供足够改善时考虑手术。

全踝关节置换术用人工植入物替换您踝关节中磨损的表面。它是终末期踝关节炎的两种手术之一；另一种是踝关节融合术，即让骨骼生长在一起。我们将与您详细讨论这两种方案。患者对踝关节置换术的满意度通常超过 90%，该手术旨在缓解疼痛并恢复活动度，使您能够更舒适地行走和保持活跃。

术前

一旦确定手术计划，我们将安排必要的影像学检查以做准备：包括您的踝关节负重位X光片，有时还需进行磁共振成像（MRI）或超声检查，以仔细评估关节、软骨及其周围的软组织。手术当天，您需要在术前七小时停止进食和饮水。我们要求禁食七小时而非更短的时间，以便如果手术室手术列表提前结束，我们可以将您的手术提前进行。某些药物需要在术前暂停；您的外科医生会告知您哪些药物以及何时停止服用。请携带一份您正在服用的所有药物的书面清单，穿着宽松舒适的衣物，并安排事后的司机送您回家。如果您有其他基础疾病，可能需要进行血液检查或接受麻醉医生的评估。

手术当日

您将前往医院的手术入院病区，在此办理入院手续并进行术前准备。您将与负责您麻醉管理的麻醉师见面。本手术在全身麻醉下进行。有时会追加区域神经阻滞以缓解术后疼痛；麻醉师将在手术当日就此与您沟通。随后，您将被带入手术室进行手术。

您将在复苏室苏醒，护士会在此监护您直至麻醉作用消退。待您的生命体征稳定后，将根据手术类型及恢复情况，决定您是转入病房还是直接回家。

手术内容

全踝关节置换术用人工部件替换踝关节磨损的表面，这些部件通常由金属和塑料制成。外科医生会移除踝关节处相互接触的两块骨端受损的骨骼和软骨，然后将其塑形以适配新的关节面。新部件被固定到位，使其能够像健康踝关节一样顺畅地相对运动。

手术通过踝关节前部的切口进行。某些设计还使用一根短柄，置于小腿主骨内部以固定植入物。如果这有助于术后踝关节更好地弯曲，外科医生可能还会在同一手术中延长踝关节后部紧绷的肌腱。

植入物就位并检查无误后，切口用缝线缝合，并覆盖敷料。如恢复部分所述，您将保留该敷料约10天。

具体使用的植入物因情况而异，随着外科医生对哪些形状和材料效果良好了解得更多，设计也在不断改进。在手术前，您的外科医生会向您说明踝关节的治疗计划，包括根据您的扫描结果是否需要额外的步骤。

术后

您将在恢复区醒来，麻醉消退期间会有护士看护。待生命体征平稳后，您将被转入病房或回家。您的医疗团队会告知您是当天出院还是住院观察一晚。在麻醉消退前，我们会为您安排镇痛措施；如果疼痛未得到缓解，请告知您的护士。您的踝关节将用敷料包扎，敷料需保留约10天；除非我们另行通知，否则请勿提前拆除。我们会在复诊时为您更换或拆除敷料。术后不久，您将在拐杖或助行器的辅助下尝试站立并行走几步。回家后，前24小时内应有人陪同。

恢复

最初几天主要关注休息和肿胀。您的脚踝会感到疼痛和肿胀，皮肤可能出现瘀伤。将脚抬高至高于心脏水平、使用毛巾包裹的冰袋冷敷，以及按处方服用止痛药，都有助于缓解这些症状。肿胀通常在最初几天达到高峰，随后逐渐消退。肿胀可能会反复出现一段时间，尤其是在您长时间站立之后。

手术后不久，您将在拐杖或助行器的辅助下站立并迈出几步。您的物理治疗师将指导您进行锻炼，以保持腿部其他部位的活动度；一旦您的外科医生确认愈合情况良好，便会开始锻炼以增强脚踝本身的活动度和力量。在脚踝恢复稳定期间，您需要穿着靴子或类似的支撑装置，并会被告知如何在脚部准备好时逐步负重。在家中，坐着时请将脚抬高，按建议进行短距离行走，并避免长时间站立。仰卧并将脚抬高通常是最舒适的睡姿。

每个人的恢复情况各不相同。有些人比其他人在脚上站稳得更快，肿胀可能会持续比预期更长时间，但这并不意味着有任何问题。您的恢复时间线可能与他人不同，您的外科医生和物理治疗师将在每个阶段为您提供指导。一旦肿胀消退且脚踝活动更加自如，您会发现行走和日常活动逐渐变得轻松。

可能出现的问题

大多数患者恢复良好，但偶尔也可能出现问题。您的外科医生和医疗团队会密切监测您的状况，以便尽早发现任何问题。

有时，新关节周围的骨骼会缓慢磨损。您可能会注意到植入物附近有钝痛，或者感觉踝关节不如以前稳定。这种情况会在复查的X光片上被发现，因此即使您的踝关节感觉正常，也请坚持按时复诊。如果早期发现磨损，通常可以在不重新进行整个置换手术的情况下进行处理。

新关节周围的感染并不常见，但很严重。请留意以下症状：简单的止痛药无法缓解的深部搏动性疼痛、从伤口向外扩散的红肿，或切口处有液体渗出。您可能会感到发热和发冷。如果您注意到上述任何症状，请立即告知我们；如果您感觉不适，请前往急诊科。

血凝块可能导致小腿突然肿胀和压痛，有时伴有腿部发热或沉重感。如果血凝块移动到肺部，可能会引起呼吸困难或胸痛。这些迹象需要紧急处理，因此请前往急诊科或呼叫急救，不要等待。

在植入新部件时，踝关节边缘的骨骼可能会开裂。这通常在手术过程中被发现并处理，但术后可能需要更长时间穿着靴子或石膏固定。如果您在手术后不久感觉踝关节两侧骨性突起处出现新的锐痛，请告知我们。

踝关节前部的伤口可能愈合缓慢。请留意伤口边缘裂开、红肿加重或渗液。请在复查时提及，或致电诊所，因为有些伤口需要我们的团队进行额外护理。

有时，新关节附近可能会形成额外的骨赘，导致踝关节前部出现挤压感，尤其是在您向上弯曲脚部时。如果这种疼痛持续存在，可以通过一个小孔手术将其清除。

如果置换关节在多年后磨损或失效，仍有其他选择。这些选择包括再次置换或踝关节融合术，即让骨骼生长在一起。

如果您想了解具体数据，本页上的并发症表格列出了典型的发病率。

何时联系我们

大多数问题在早期就会显现，及时处理可使治疗更容易。如果您出现发热、伤口红肿或渗出液增多，或疼痛持续加重而非缓解，请致电我们。如果您出现小腿突然肿胀或压痛、呼吸困难或胸痛，请立即前往急诊，因为这些可能是血凝块的征兆。如果您出现足部感觉丧失或无法活动足部，请立即前往急诊。如果您不确定某种情况是否正常，请致电诊所，我们将帮助您判断。

Reviewed by AI synthesis (v2) — pending human review · 9 September 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Anatomy & Pathophysiology

Bony Anatomy

  • The ankle mortise is formed by the tibial plafond, medial malleolus, and lateral malleolus [5].
  • The ankle mortise articulates with the dome of the talar body [5].
  • The talar dome is wider anteriorly and narrower posteriorly [5].
  • The ankle mortise widens 1 to 1.5 mm during motion from plantar flexion to dorsiflexion [5].
  • Medial and superior clear spaces appear wider with the foot in plantar flexion [5].
  • A simplified model of the ankle joint has a horizontal axis from anteromedial to posterolateral [5].
  • A simplified model of the ankle joint has a coronal axis from superomedial directed distally and laterally to the tip of the fibula [5].
  • The distal fibula has a convex medial surface [5].
  • The incisura fibularis is the concave surface of the distal lateral tibia [5].
  • The fibula rotates approximately 2 degrees within the incisura during ankle motion and ambulation [5].
  • Ankle dorsiflexion results in external rotation and proximal translation of the fibula [5].

Ligamentous Anatomy

  • Lateral ankle ligaments function as restraints to varus and inversion forces at the ankle [5].
  • The anterior talofibular ligament (ATFL) originates from the anteroinferior aspect of the lateral malleolus, 1 cm proximal to its tip [5].
  • The anterior talofibular ligament extends to the lateral aspect of the talar neck [5].
  • The calcaneofibular ligament (CFL) extends from the tip of the lateral malleolus to the lateral aspect of the calcaneus [5].
  • The posterior talofibular ligament (PTFL) extends from the posterior lateral malleolus to the posterolateral talus [5].
  • The ATFL is the weakest ankle ligament [5].
  • The PTFL is the strongest ankle ligament [5].
  • The distal tibiofibular joint and fibula provide stability against lateral talar translation [5].
  • The deltoid ligament complex is the primary ankle stabilizer during stance [5].
  • The deep deltoid ligament extends from the apex of the medial malleolus to the medial talar body [5].
  • The deep deltoid ligament functions primarily to resist lateral talar translation and external rotation [5].
  • The posterior deep deltoid is the most important component of the deep deltoid ligament [5].
  • The superficial deltoid ligament extends from the distal medial malleolus to the navicular bone, sustentaculum tali of calcaneus, medial talus, and spring ligament [5].
  • The superficial deltoid ligament functions primarily to resist valgus and eversion ankle forces [5].
  • The deltoid ligament consists of superficial and deep layers, with at most six bands [11].
  • Only three bands of the deltoid ligament are constant: the tibionavicular ligament, tibiospring ligament, and deep posterior tibiotalar ligament [11].
  • The superficial layer of the deltoid ligament originates from the anterior malleolus and inserts into the navicular, neck of the talus, sustentaculum tali, and posteromedial talar tubercle [11].
  • The tibiocalcaneal portion of the superficial deltoid ligament is the strongest component and resists eversion of the calcaneus [11].
  • The deep portion of the deltoid ligament is the primary medial stabilizer of the ankle joint [11].
  • The deep deltoid ligament is organized into two short, thick, discrete bands: the anterior and posterior deep tibiotalar ligaments [11].
  • The anterior and posterior deep tibiotalar ligaments are intra-articular but extrasynovial [11].
  • The deep posterior band comprises the largest band of the deltoid complex [11].
  • The anterior deep tibiotalar ligament arises from the anterior malleolus and attaches to the medial aspect of the talus [11].
  • The posterior deep tibiotalar ligament originates from the posterior malleolus and inserts on the medial body of the talus [11].
  • The deltoid ligament has a rich vascular supply from three extraosseous sources: the medial tarsal artery, posterior tibial artery, and tibialis anterior artery [11].
  • The deltoid ligament also has intraosseous vascular supply from either the talus or the medial malleolus [11].
  • The deep deltoid ligament has the highest load to failure at 713.8 N ± 69.3 compared with the lateral collateral ligaments [11].
  • The dominant mode of failure for the deep deltoid ligament is an intrasubstance rupture near its talar insertion [11].
  • The failure of the superficial deltoid ligament is most commonly at its insertion on the anterior malleolus [11].

Biomechanics & Motion

  • The primary functions of the foot and ankle are to provide weight-bearing support and forward ambulation [5].
  • The ankle is responsible for most sagittal plane motion of the foot and ankle [5].
  • Ankle plantar flexion ranges from 23 to 48 degrees [5].
  • Ankle dorsiflexion ranges from 10 to 23 degrees [5].
  • The ankle contributes to inversion, eversion, and rotation [5].

Neurovascular Anatomy

  • The superficial peroneal nerve penetrates the deep fascia and lies subcutaneously 8 to 10 cm proximal to the tip of the lateral malleolus [9].
  • The anterior tibial artery can be palpated beneath the superior extensor retinaculum 4 to 5 cm proximal to the distal articular surface of the tibia [9].
  • The deep peroneal nerve accompanies the anterior tibial artery and lies between the tendons of the anterior tibial and extensor digitorum longus [9].
  • The deep peroneal nerve lies just lateral to the anterior tibial artery [9].
  • The saphenous nerve is located just medial or posterior to the saphenous vein in a slightly deeper plane 3 to 5 cm proximal to the tip of the medial malleolus [9].

Pathophysiology of Injury

  • More than 75% of ankle ligament injuries involve the lateral ligament complex, particularly the ATFL and CFL [12].
  • Medial ligament injuries are usually seen in association with a fracture or joint injury [12].
  • In an ATFL sprain, tenderness is maximal just distal and slightly anterior to the lateral malleolus [12].
  • The deltoid ligament primarily prohibits eversion and abduction [11].
  • The deep deltoid ligament resists external rotation when the foot is dorsiflexed [11].
  • The deep deltoid ligament is responsible for the greatest restraint against lateral translation [11].
  • Valgus tilting of the talus within the mortise requires complete rupture of both the superficial and deep deltoid ligaments [11].
  • Isolated rupture of the deltoid ligament without lateral ligamentous or fibular injury is rare [11].
  • Syndesmotic injury, lateral ligamentous injury, and fibular fractures are common associations with deltoid injury [11].
  • The criteria for diagnosis of medial instability include a feeling of giving way, medial ankle joint pain, and a correctable valgus or pronation deformity [11].
  • Medial instability is reinforced by excess motion in external rotation, eversion, valgus, and/or posterior translation [11].
  • With complete deltoid injury, a valgus AP stress radiograph shows talar tilt and/or lateral translation of the talus [11].
  • Most incomplete deltoid injuries are normal on standard radiographic imaging [11].
  • MRI is the imaging modality of choice for defining injury to the deltoid ligaments and associated structures [11].
  • Ankle arthroscopy allows direct assessment of the deltoid ligament with lateral stress applied to the talus [11].

Investigations

Osteochondral Lesions

  • Osteochondral lesions of the ankle are seen in up to 70% of ankle sprains and 75% of ankle fractures [15, 16].
  • The most common location for osteochondral lesions is the medial talar dome [15, 16].
  • Modern data indicate that the most common location for medial talar dome lesions is central, contradicting historical beliefs that the posterior location was more common [15, 16].
  • Medial talar dome lesions are larger and deeper than lateral lesions [15, 16].
  • Lateral talar dome lesions are less common than medial lesions [15, 16].
  • Lateral talar dome lesions are more often unstable, displaced, or symptomatic than medial lesions [15, 16].
  • Lateral talar dome lesions are often refractory to conservative measures [15, 16].
  • Physical examination for osteochondral lesions demonstrates deep pain over the ankle joint line [15, 16].
  • Palpation often does not reproduce the symptoms described by patients with osteochondral lesions [15, 16].
  • Ankle effusion is common in patients with osteochondral lesions [15, 16].
  • AP, mortise, and lateral weight-bearing ankle x-rays may not demonstrate subtle osteochondral lesions [15, 16].
  • CT scan is helpful for determining the integrity of subchondral bone and identifying cysts in osteochondral lesions [15, 16].
  • MRI is sensitive for all osteochondral lesions [15, 16].
  • The edema pattern on MRI frequently overestimates the severity of osteochondral injury [15, 16].
  • Linear fluid signal deep to subchondral bone on MRI indicates an unstable osteochondral injury [15, 16].
  • MRI has a sensitivity of 92% for predicting stable versus unstable osteochondral lesions [15, 16].

General Imaging and Diagnosis

  • Advanced imaging is often helpful in the diagnosis of foot and ankle injuries when combined with a thorough clinical examination [18].
  • MRI is used for the evaluation of tibiofibular syndesmotic ligaments [3].
  • MRI is used for the evaluation of posterior tibial tendon dysfunction [3].
  • MRI is used for the evaluation of anterolateral soft tissue impingement of the ankle [3, 20].
  • MRI is used for the evaluation of osteochondral lesions of the talus [3].
  • MRI is used for the diagnosis of ligamentous and chondral pathology in the ankle [3].
  • MRI and stress radiography are used in the evaluation of chronic lateral ankle instability [3].
  • MRI is used in the pre-operative evaluation of the anterior talofibular ligament in chronic ankle instability [3].
  • MRI is used for the diagnosis of ruptures of the tibialis posterior tendon [3].
  • MRI is used for the imaging evaluation of traumatic ligamentous injuries of the ankle and foot [3].
  • MRI is used for the diagnosis of plantar plate injury [3].
  • MRI findings are associated with symptoms in patients with chronic ankle sprain [3].
  • MRI is used for the evaluation of chronic Achilles tendon ruptures [3].
  • MRI is used for the evaluation of peroneal tendon abnormalities [17].
  • MR imaging is used for the evaluation of entrapment neuropathies of the lower extremity, including the ankle and foot [21].
  • Ultrasonography is used for the examination of the deltoid ligament in bimalleolar equivalent fractures [19].
  • Point-of-care ultrasonography is used in the diagnosis and management of superficial peroneal nerve entrapment [21].
  • MRI lacks additional diagnostic value for stability assessment of the ankle mortise in supination-external rotation-type ankle fractures [19].
  • Preoperative computed tomography scans are used in operative planning for malleolar ankle fractures [19].
  • Axial CT imaging is used to evaluate normal tibiofibular relationships at the syndesmosis [19].
  • Radiographic evaluation of the normal distal tibiofibular syndesmosis is a standard diagnostic consideration [19].
  • Fluoroscopy is used to assess if the syndesmosis is reduced [19].
  • The ankle fracture spur sign is pathognomonic for a variant ankle fracture [19].
  • Evaluation of posterior malleolar fractures and the posterior pilon variant is performed in operatively treated ankle fractures [19].
  • Stability criteria for nonoperative ankle fracture management are established via radiographic assessment [19].
  • Gravity stress radiographs are used to assess deltoid ligament integrity and medial clear space measurements [4].
  • Radiographic identification of primary lateral ankle structures is possible [4].
  • Comparison of magnetic resonance imaging to physical examination is performed for syndesmotic injury after lateral ankle sprain [4].

Treatment

Complications and Revision

  • Revision of failed total ankle arthroplasty can be performed as a hindfoot fusion [1].
  • Infection in total ankle arthroplasty requires specific diagnostic and treatment protocols [1].
  • Patient-related risk factors for periprosthetic joint infection have been analyzed in a cohort of 6977 total ankle arthroplasties [1].
  • Risk factors for symptomatic deep-vein thrombosis exist in patients after total ankle replacement who received routine chemical thromboprophylaxis [1].
  • Perioperative outcomes of total ankle arthroplasty differ when performed at an orthopaedic specialty hospital versus an academic teaching hospital [1].
  • Salvage of failed total ankle arthroplasty can be achieved with fusion using structural allograft and internal fixation [1].
  • Bone lysis of the AES total ankle replacement is subject to clinical evaluation and radiographic assessment [1].
  • Heterotopic ossification can occur after total ankle arthroplasty [1].
  • Risks associated with total ankle arthroplasty have been evaluated in the literature [1].
  • Short-term complications are associated with procedures performed through separate incisions during total ankle replacement [1].
  • The ankle arthritis score is associated with the need for revision surgery [1].
  • Patient risk factors do not impact 90-day readmission and emergency department visitation after total ankle arthroplasty [1].
  • Supramalleolar osteotomy is a treatment for tibial component malposition in total ankle replacement [1].
  • Hindfoot arthritis progression and arthrodesis risk occur after total ankle replacement [1].
  • Arthroscopic debridement is a management option after total ankle arthroplasty [1].
  • Failures of total ankle replacement can be managed with the Agility total ankle arthroplasty [1].
  • Blood transfusion during total ankle arthroplasty is associated with increased in-hospital complications and cost [1].
  • A three-grade classification of complications has been assessed for total ankle replacement [1].
  • Soft tissue reconstruction is performed after total ankle arthroplasty [1].
  • Operative wound complications occur following total ankle arthroplasty [1].
  • Bone grafting of bone cysts is an outcome management strategy after total ankle arthroplasty [1].
  • Secondary arthrodesis is performed after total ankle arthroplasty [1].
  • Short-term perioperative complications and mortality occur after total ankle arthroplasty in the United States [1].
  • The incidence of symptomatic thromboembolic events is low after total ankle arthroplasty without routine use of chemoprophylaxis [1].
  • Evaluation and management strategies exist for the painful total ankle arthroplasty [1].
  • Anterior heterotopic ossification at the talar neck can occur after total ankle arthroplasty [1].
  • Salvage arthrodesis is performed for failed total ankle replacement [1].
  • Platelet-rich plasma has been evaluated for its efficacy in incision healing after total ankle replacement using the Agility system [1].
  • Computed tomography has been evaluated for its added information on radiographic analysis in detecting periprosthetic osteolysis after total ankle arthroplasty [1].
  • The impact of complications in total ankle replacement and ankle arthrodesis has been analyzed with a validated outcome measurement [1].
  • Revision rates after total ankle arthroplasty have been reported in sample-based clinical studies and national registries [1].
  • Acute hematogenous periprosthetic joint infection in total ankle arthroplasty can be treated with irrigation, debridement, and polyethylene exchange [1].
  • Cigarette use is associated with complication rates and outcomes following total ankle arthroplasty [1].
  • Heterotopic ossification occurs after primary total ankle arthroplasty [1].
  • Delayed onset medial malleolar pain following total ankle arthroplasty has a defined etiology and treatment [1].
  • Periprosthetic fractures occur in total ankle replacement [1].
  • Postoperative range of motion trends have been documented following total ankle arthroplasty [2].
  • Total ankle arthroplasty outcomes have been compared for post-traumatic and primary osteoarthritis [2].
  • Total ankle arthroplasty has been reported in France [2].
  • Results of total ankle arthroplasty have been published [2].
  • The success of current ankle replacements has been evaluated in a systematic review of the literature [2].
  • The 10-year survival of total ankle arthroplasties was reported on 780 cases from the Swedish ankle register [2].
  • Outcomes after total ankle arthroplasty have been reported from worldwide arthroplasty registers [2].
  • Trends in total ankle arthroplasty and revisions have been analyzed in the Medicare database [2].
  • Inconsistency in the reporting of adverse events in total ankle arthroplasty has been identified in a systematic review [2].
  • Trends in the use of total ankle replacement and ankle arthrodesis have been analyzed in the United States Medicare population [2].
  • Changes in pain, function, and gait mechanics two years following total ankle arthroplasty performed with two modern fixed-bearing prostheses have been documented [2].
  • Trends in treatment of advanced ankle arthropathy by total ankle replacement or ankle fusion have been analyzed [2].
  • The utilization of total ankle replacement in the United States has been assessed [2].
  • Total ankle replacement was studied in a population-based study of 515 cases from the Finnish arthroplasty registry [2].
  • Practice patterns in total ankle replacement and ankle fusion in the United States have been compared [2].
  • Patient and practice trends in total ankle replacement and ankle arthrodesis in the United States from 2007 to 2013 have been analyzed [2].
  • The evolution of the technology and future applications of total ankle replacement have been discussed [2].

Complications

  • Revision of failed total ankle arthroplasty to a hindfoot fusion is a documented salvage procedure [1].
  • Perioperative outcomes for total ankle arthroplasty differ when performed at an orthopaedic specialty hospital versus an academic teaching hospital [1].
  • Salvage of failed total ankle arthroplasty can be performed with fusion using structural allograft and internal fixation [1].
  • Heterotopic ossification is a recognized complication after total ankle arthroplasty [1].
  • The risks associated with total ankle arthroplasty have been specifically evaluated [1].
  • Supramalleolar osteotomy is used to treat tibial component malposition in total ankle replacement [1].
  • A three-grade classification of complications in total ankle replacement has been assessed [1].
  • Anterior heterotopic ossification at the talar neck occurs after total ankle arthroplasty [1].
  • Computed tomography has been evaluated for its ability to add information on radiographic analysis in detecting periprosthetic osteolysis after total ankle arthroplasty [1].
  • The impact of complications in total ankle replacement and ankle arthrodesis has been analyzed using a validated outcome measurement [1].
  • Inconsistency exists in the reporting of adverse events in total ankle arthroplasty [2].

References

[1] Campbell S Operative Orthopaedics 4 Volume Set. Reported Outcomes of Ankle Arthroplasty Compared With Ankle Arthrodesis > COMPLICATIONS AND REVISION.

[2] Campbell S Operative Orthopaedics 4 Volume Set. Reported Outcomes of Ankle Arthroplasty Compared With Ankle Arthrodesis > REFERENCES.

[3] Campbell S Operative Orthopaedics 4 Volume Set. REFERENCES > FOOT AND ANKLE.

[4] Campbell S Operative Orthopaedics 4 Volume Set. REPAIR OF ACUTE RUPTURE OF LATERAL LIGAMENTS > ACUTE ANKLE LIGAMENT INJURIES, CHRONIC ANKLE INSTABILITY.

[5] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > BIOMECHANICS OF THE FOOT AND ANKLE.

[9] Campbell S Operative Orthopaedics 4 Volume Set. MULTIPLE Z-PLASTY RELEASE OF A CONGENITAL RING > ANKLE BLOCK.

[11] Orthopaedic Knowledge Update Sports Medicine 6. Ankle and Foot Injuries and Other Disorders > Ankle Sprains > Medial Ankle Injury.

[12] Apley And Solomon S Concise System Of Orthopaedics And Trauma. INJURIES OF THE ANKLE.

[15] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > OSTEOCHONDRAL LESIONS.

[16] Miller S Review Of Orthopaedics. OSTEOCHONDRAL LESIONS.

[17] Campbell S Operative Orthopaedics 4 Volume Set. MULTIPLE Z-PLASTY RELEASE OF A CONGENITAL RING > PERONEAL TENDONS.

[18] Orthopaedic Knowledge Update Sports Medicine 6. Ankle and Foot Injuries and Other Disorders > Summary.

[19] Orthopaedic Knowledge Update Trauma. Ankle Fractures > Annotated References.

[20] Campbell S Operative Orthopaedics 4 Volume Set. ARTHROSCOPIC EXAMINATION AND DEBRIDEMENT OF THE ANKLE JOINT > IMPINGEMENT.

[21] Campbell S Operative Orthopaedics 4 Volume Set. COMBINED HAMMER TOE AND MALLET TOE DEFORMITY WITH ASSOCIATED DOUBLE CORNS > REFERENCES > TARSAL TUNNEL SYNDROME.

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.