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现役军人中改良 Broström 手术的术后结果:一项回顾性队列研究

Postoperative Outcome of the Modified Broström Procedure in the Active Duty Military Population: A Retrospective Cohort Study.

作者信息

Melton Thomas J, Dannenbaum Joseph H, Drayer Nicholas J, Robbins Justin, Ryan Paul M

机构信息

Surgeon, Madigan Army Medical Center, Tacoma, WA.

Surgeon, Madigan Army Medical Center, Tacoma, WA.

出版信息

J Foot Ankle Surg. 2018 May-Jun;57(3):527-530. doi: 10.1053/j.jfas.2017.11.026.

Abstract

Ankle sprains are common injuries and typically treated conservatively. Chronic ankle instability, however, can require surgery when nonoperative measures fail. We evaluated the clinical outcomes of an active duty population in a retrospective study of patients who had undergone a modified Broström procedure at our facility from January 2010 through April 2014 by a single surgeon. The electronic medical records and Army E-profile database were reviewed to determine whether the patients had returned to active duty and whether they had any permanent postoperative lower extremity activity restrictions. A total of 127 patients met the inclusion criteria and had undergone the modified Broström procedure during the study period; 34 (26.8%) separated from the military postoperatively. Of these 34 patients, 23 (18.1%) were unfit for reasons related to their ankle and 11 (8.7%) required military separation for reasons unrelated to their ankle. Thus, 93 patients (73.2%) were able to remain on active duty after undergoing the Broström procedure. Of the 93 patients able to remain on active duty, 38 (40.9%) required activity modifications and 55 (59.1%) were able to return to full duty. Chronic ankle instability in active duty patients can be severely limiting. The modified Broström procedure can provide significant improvement in symptoms and allow patients to remain on active duty. In our high-demand population, ~73% of patients were able to remain on active duty after their injury and subsequent surgery, 60% of whom returned to their previous level of duty without any physical restrictions.

摘要

踝关节扭伤是常见损伤,通常采用保守治疗。然而,慢性踝关节不稳在非手术治疗措施失败时可能需要手术治疗。我们通过一项回顾性研究评估了现役军人患者的临床结局,这些患者于2010年1月至2014年4月在我们机构由同一位外科医生接受了改良Broström手术。查阅电子病历和陆军人员档案数据库,以确定患者是否重返现役以及术后是否有任何永久性下肢活动受限。共有127例患者符合纳入标准,并在研究期间接受了改良Broström手术;34例(26.8%)术后从军队退役。在这34例患者中,23例(18.1%)因踝关节相关原因不适合服役,11例(8.7%)因与踝关节无关的原因需要退役。因此,93例患者(73.2%)在接受Broström手术后能够继续服现役。在93例能够继续服现役的患者中,38例(40.9%)需要调整活动,55例(59.1%)能够恢复全职服役。现役患者的慢性踝关节不稳可能会严重限制其行动。改良Broström手术可显著改善症状,并使患者能够继续服现役。在我们这个高要求的人群中,约73%的患者在受伤及随后手术后能够继续服现役,其中60%的患者恢复到之前的服役水平且没有任何身体限制。

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