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改良 Broström 技术治疗早期、中期和延迟就诊的慢性踝关节不稳的临床疗效

Clinical Outcomes of the Modified Broström Technique in the Management of Chronic Ankle Instability After Early, Intermediate, and Delayed Presentation.

作者信息

Hassan Sami, Thurston Daniel, Sian Tanvir, Shah Rohi, Aziz Abdul, Kothari Paresh

机构信息

Orthopaedic Registrar, Department of Trauma and Orthopaedics, King's Mill Hospital, Sutton-in-Ashfield, United Kingdom.

Surgical Trainee, Department of Trauma and Orthopaedics, Queens Medical Centre, Nottingham, United Kingdom.

出版信息

J Foot Ankle Surg. 2018 Jul-Aug;57(4):685-688. doi: 10.1053/j.jfas.2017.12.003. Epub 2018 Apr 11.

Abstract

The modified Broström technique (MBT) is considered the reference standard for surgical management of ankle instability, with good short-term outcomes. However, limited evidence is available regarding outcomes for delayed presentations of instability. We report our outcomes for patients who underwent ligament repair using the MBT, from a single-surgeon retrospective study of consecutive patients. The minimum postoperative follow-up period was 6 months during a 5-year study period. The patients were retrospectively divided into 3 groups according to the delay in presentation: group 1, 6 months to 2 years; group 2, 2 to 4 years; and group 3, >4 years. We collected data on patient demographics, injury pattern, and intraoperative surgeon findings. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale (AHS) was used to evaluate patient outcomes and satisfaction with surgery. Twenty-six patients were treated with MBT. The mean follow-up period was 36.9 (range 6-42) months. Twenty-five (96.2%) patients had unilateral injuries, and 1 (3.85%) had bilateral repairs. Of the 26 patients, 21 (80.8%) completed the AOFAS-AHS, with a mean score of 87.4 (range 12 to 100). The mean interval from injury to surgery was 47.9 months. The results were excellent in 15 (71.4%), good in 3 (14.3%), fair in 1 (4.8%), and poor in 2 (9.5%) using the AOFAS-AHS. We found no significant difference in the overall AOFAS-AHS score or postoperative satisfaction among the groups (p > .05). All patients had a stable ankle joint at their final follow-up visit. In conclusion, patients with persistent or chronic ankle instability have good clinical outcomes and satisfaction after the MBT, irrespective of the time from injury to presentation.

摘要

改良 Broström 技术(MBT)被认为是踝关节不稳手术治疗的参考标准,短期疗效良好。然而,关于延迟出现的踝关节不稳的治疗效果,现有证据有限。我们报告了在一项由单一外科医生进行的连续患者回顾性研究中,接受 MBT 韧带修复的患者的治疗效果。在为期 5 年的研究期间,术后最短随访期为 6 个月。根据就诊延迟情况,将患者回顾性分为 3 组:第 1 组,6 个月至 2 年;第 2 组,2 至 4 年;第 3 组,>4 年。我们收集了患者人口统计学、损伤模式和术中外科医生发现的数据。采用美国矫形足踝协会(AOFAS)踝 - 后足评分量表(AHS)评估患者的治疗效果及对手术的满意度。26 例患者接受了 MBT 治疗。平均随访期为 36.9(范围 6 - 42)个月。25 例(96.2%)患者为单侧损伤,1 例(3.85%)为双侧修复。26 例患者中,21 例(80.8%)完成了 AOFAS - AHS 评分,平均得分为 87.4(范围 12 至 100)。受伤至手术的平均间隔时间为 47.9 个月。根据 AOFAS - AHS 评分,结果为优的有 15 例(71.4%),良的有 3 例(14.3%),可的有 1 例(4.8%),差的有 2 例(9.5%)。我们发现各组之间的总体 AOFAS - AHS 评分或术后满意度无显著差异(p > 0.05)。所有患者在最后一次随访时踝关节均稳定。总之,无论从受伤到就诊的时间长短,持续性或慢性踝关节不稳患者在接受 MBT 治疗后均有良好的临床效果和满意度。

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