Li Xinning, Killie Heather, Guerrero Patrick, Busconi Brian D
University of Massachusetts Medical Center, Division of Sports Medicine, Department of Orthopaedic Surgery, Room S4-827, 55 Lake Avenue North, Worcester, MA 01655, USA.
Am J Sports Med. 2009 Mar;37(3):488-94. doi: 10.1177/0363546508327541.
Modification of the Bröstrom repair with suture anchors has been used to address chronic lateral ankle instability. However, there are few studies in the literature reporting the functional outcomes after this particular procedure in the high-demand athlete.
Anatomical reconstruction of the lateral ankle ligaments for chronic instability will return the high-demand athlete functionally to his or her previous level of activity.
Case series; Level of evidence, 4.
Sixty-two patients who had grade III ankle sprain that failed at least a 6-month course of supervised conservative management with a preinjury Tegner score of > or = 6 underwent a variant of the Gould-modified Broström procedure with suture anchors for lateral ankle instability. Each patient was given the Tegner and Karlsson questionnaire at the 6-month, 1-year, and 2-year time points. Range of motion of the operative ankle was also assessed. The mean age was 19.6 years (range, 16-26 years), and 10 patients were lost to follow-up.
The mean follow-up was 29 months (minimum, 24 months) in the remaining 52 patients (84%). Mean Tegner scores at the 1- and 2-year time points were 8.2 (range, 5-9) and 8.6 (range, 5-9), respectively. The mean Karlsson scores were 92 +/- 5.2 and 95 +/- 3.1 at the 1- and 2-year time points, respectively. Range of motion was equal to the contralateral ankle in all but 3 patients at the 2-year follow up. A 6% major complication rate included 3 reruptures.
Anatomical ligament reconstruction for chronic lateral ankle instability using a variant of the Gould-modified Broström procedure with suture anchors was effective in returning high-demand athletes to their preinjury functional level.
采用缝线锚钉改良的布罗斯特伦修复术已被用于治疗慢性外侧踝关节不稳。然而，文献中很少有研究报道该特定手术在高需求运动员中的功能预后。
针对慢性不稳进行外侧踝关节韧带的解剖重建，将使高需求运动员在功能上恢复到其伤前的活动水平。
病例系列；证据等级，4级。
62例III度踝关节扭伤患者，经至少6个月的有监督的保守治疗失败，伤前泰格纳评分≥6分，接受了采用缝线锚钉治疗外侧踝关节不稳的古尔德改良布罗斯特伦手术的一种术式。在6个月、1年和2年时间点，对每位患者进行泰格纳和卡尔松问卷调查。还评估了患侧踝关节的活动范围。平均年龄为19.6岁（范围16 - 26岁），10例患者失访。
其余52例患者（84%）的平均随访时间为29个月（最短24个月）。1年和2年时间点的平均泰格纳评分分别为8.2（范围5 - 9）和8.6（范围5 - 9）。1年和2年时间点的平均卡尔松评分分别为92±5.2和95±3.1。在2年随访时，除3例患者外，其余患者的踝关节活动范围与对侧相等。主要并发症发生率为6%，包括3例再断裂。
采用缝线锚钉的古尔德改良布罗斯特伦手术术式对慢性外侧踝关节不稳进行解剖韧带重建，可有效使高需求运动员恢复到伤前的功能水平。
