Medicine:Evans technique

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Evans technique
Specialtyorthopedic

The Evans technique is a surgical procedure to treat the mechanical instability of the lateral ankle ligaments.[1][2]

In the Evans procedure,[3] the peroneus brevis muscle is separated from its musculotendinous compound and its proximal end is sutured to the peroneus longus. Then, an aperture is created from the postero-superior side of the fibula to the lateral malleolar tip. The tendon is then passed from the anterior side towards the posterior side through this aperture and sutured on itself. This procedure was designed to prevent talar tilt by reducing foot inversion and deterring chronic ankle instability.[4]

The disadvantage of the Evans procedure is its inability to restore the normal anatomical position of the anterior talofibular ligament. Hence, the stability at inversion is restored. The plantar pressure changes after the modified Evans procedure have not been measured. It is hypothesized that the modified Evans procedure will improve plantar pressure balance in lateral ankle instability.[5]

References

  1. Tindall, S. F., and S. H. Heaney. "Repair of the lateral ligaments of the ankle by the Evans technique." J Bone Joint Surg [Br] 58 (1976): S133.
  2. EVANS DL (May 1953). "Recurrent instability of the ankle; a method of surgical treatment". Proceedings of the Royal Society of Medicine 46 (5): 343–4. doi:10.1177/003591575304600507. PMID 13055916. 
  3. Ateşalp, S.; Demiralp, B.; Ozkal, U. B.; Uğurlu, M.; Bozkurt, M.; Başbozkurt, M. (2009). "Modified Evans technique improves plantar pressure distribution in lateral ankle instability". Eklem Hastalik Cerrahisi 20 (1): 41–6. PMID 19522690. 
  4. Peters, J. W.; Trevino, S. G.; Renstrom, P. A. (1991). "Chronic Lateral Ankle Instability". Foot & Ankle International 12 (3): 182–191. doi:10.1177/107110079101200310. ISSN 1071-1007. PMID 1791012. 
  5. Rosenbaum, D.; Becker, H.-P.; Sterk, J.; Gerngross, H.; Claes, L. (1997). "Functional Evaluation of the 10-Year Outcome after Modified Evans Repair for Chronic Ankle Instability". Foot & Ankle International 18 (12): 765–771. doi:10.1177/107110079701801202. ISSN 1071-1007. PMID 9429877.