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“全关节镜下” 布罗斯特伦手术与传统开放性改良布罗斯特伦-古尔德技术的比较:62例患者的回顾

A comparison of the "All-Inside" arthroscopic Broström procedure with the traditional open modified Broström-Gould technique: A review of 62 patients.

作者信息

Rigby Ryan B, Cottom James M

机构信息

Logan Regional Orthopedics and Sports Medicine, 1300 N. 500 E. Ste 130, Logan, UT 84341, United States.

Florida Orthopedic Foot & Ankle Center, 2030 Bee Ridge Rd Suite B, Sarasota, FL 34239, United States.

出版信息

Foot Ankle Surg. 2019 Feb;25(1):31-36. doi: 10.1016/j.fas.2017.07.642. Epub 2018 Feb 9.

Abstract

BACKGROUND

The open Broström-Gould lateral ankle stabilization procedure has been the gold standard for primary lateral ankle stabilization. A new minimally invasive all-inside arthroscopic technique has been described for the correction of lateral ankle instability.

METHODS

We performed a review of patients who underwent lateral ankle stabilization by either the traditional open Broström-Gould (BG) or the All-Inside Bröstrom (AIB) technique to compare and identify any discrepancies between functional and/or patient satisfaction outcomes. A total of 62 patients underwent a lateral ankle stabilization. Of those 62 patients, 32 received a traditional open Broström-Gould procedure and 30 patients underwent an All-Inside Bröstrom type procedure. The two groups were compared preoperatively with AOFAS ankle-hindfoot scoring system and Visual Analog Score (VAS) for pain. Postoperatively, AOFAS, Karlsson Peterson and VAS scores were compared.

RESULTS

The mean preoperative VAS pain score for the open Broström-Gould was 7.28, the All-Inside Broström was 8.18. The mean postoperative VAS pain score for the open Broström-Gould was 1.2, the All-Inside Broström was 1.5. The mean preoperative AOFAS score for the Broström-Gould was 35.44, the All-Inside Broström was 35.07. The mean postoperative AOFAS score for the open Broström-Gould was 93.53, the All-Inside Broström was 95.33. The mean postoperative Karlsson Peterson score for the open Broström-Gould was 93.41, the All-Inside Broström was 91.80. The mean time to weight bearing for the Broström-Gould was 22 days, the All-Inside Broström was 12 days.

CONCLUSION

There were no statistically significant differences identified in any of the functional or patient satisfaction outcome scores using either technique. This review suggests the minimally invasive arthroscopic technique using bone anchors for lateral ankle stabilization may be comparable to the traditional open Broström-Gould with the added advantage of earlier time to weight bearing.

摘要

背景

开放式布罗斯特伦-古尔德外侧踝关节稳定手术一直是初次外侧踝关节稳定手术的金标准。一种用于纠正外侧踝关节不稳的新型微创全关节镜技术已被描述。

方法

我们对采用传统开放式布罗斯特伦-古尔德(BG)或全关节镜布罗斯特伦(AIB)技术进行外侧踝关节稳定手术的患者进行了回顾性研究,以比较并确定功能和/或患者满意度结果之间的任何差异。共有62例患者接受了外侧踝关节稳定手术。在这62例患者中,有32例接受了传统开放式布罗斯特伦-古尔德手术,30例患者接受了全关节镜布罗斯特伦式手术。术前使用美国足踝外科协会(AOFAS)踝关节-后足评分系统和视觉模拟评分(VAS)评估疼痛情况,对两组进行比较。术后,比较AOFAS、卡尔松·彼得森评分和VAS评分。

结果

开放式布罗斯特伦-古尔德手术术前VAS疼痛评分均值为7.28,全关节镜布罗斯特伦手术为8.18。开放式布罗斯特伦-古尔德手术术后VAS疼痛评分均值为1.2,全关节镜布罗斯特伦手术为1.5。布罗斯特伦-古尔德手术术前AOFAS评分均值为35.44,全关节镜布罗斯特伦手术为35.07。开放式布罗斯特伦-古尔德手术术后AOFAS评分均值为93.53,全关节镜布罗斯特伦手术为95.33。开放式布罗斯特伦-古尔德手术术后卡尔松·彼得森评分均值为93.41,全关节镜布罗斯特伦手术为91.80。布罗斯特伦-古尔德手术的平均负重时间为22天,全关节镜布罗斯特伦手术为12天。

结论

使用这两种技术在任何功能或患者满意度结果评分方面均未发现统计学上的显著差异。本综述表明,使用骨锚的微创关节镜技术用于外侧踝关节稳定手术可能与传统开放式布罗斯特伦-古尔德手术相当,且具有更早负重的额外优势。

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