Hassan Sami, Thurston Daniel, Sian Tanvir, Shah Rohi, Aziz Abdul, Kothari Paresh
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.
J Foot Ankle Surg. 2018 Jul-Aug;57(4):685-688. doi: 10.1053/j.jfas.2017.12.003. Epub 2018 Apr 11.
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.
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。
