Department of Orthopaedic, Ningbo No.6 Hospital, Ningbo, China.
Department of Orthopaedic, Ningbo Medical Centre Lihuili Hospital, Ningbo, China.
Orthop Surg. 2019 Aug;11(4):671-678. doi: 10.1111/os.12516.
To compare the clinical and radiological outcome between the modified Broström repair with augmentation using suture tape (MBA) and the modified Broström repair (MB) for patients with chronic lateral ankle instability.
A retrospective study was performed in Ningbo No. 6 Hospital. The study included 53 patients who underwent surgical treatment from March 2014 to July 2016 and were followed for 2 years. A total of 25 patients underwent modified Broström repair with augmentation using suture tape, and 28 patients were treated with modified Broström repair. Patients were evaluated using the American Orthopedic Foot and Ankle Scale (AOFAS) hindfoot scale, the Foot and Ankle Ability Measure (FAAM) score, range of motion (ROM), and the visual analogue scale (VAS). The talar tilt angle (TTA) and anterior talar translation (ATT) were used to evaluate the mechanical stability. All radiological outcomes were measured by two orthopaedic surgeons, with the measurements repeated 3 days later.
The mean age of the patients was 26.6 ± 17.8 years in the MBA group and 28.1 ± 19.4 years in the MB group, and no statistical difference in preoperative data was found between two groups. There were significant differences before and after the operation within the groups. Both groups achieved satisfactory outcomes, and significant improvements (VAS, FAAM, AOFAS, TTA, and ATT) were observed between the 1-year follow-up and final follow-up (P < 0.05). The MBA group showed significant improvement in the FAAM Sport (87.1 ± 5.4 vs 78.2 ± 12.0, P = 0.001) and total scores (93.1 ± 2.3 vs 90.5 ± 5.1, P = 0.027) at the final follow-up compared with the MB group, and for the other outcomes, there were no significant differences between the two groups.
The modified Broström repair with augmentation using suture tap for chronic lateral ankle instability achieves a better outcome; however, further research is necessary.
比较慢性外侧踝关节不稳定患者采用改良 Broström 修复术（MB）联合缝线带增强（MBA）与改良 Broström 修复术（MB）的临床和影像学结果。
回顾性研究在宁波第六医院进行。该研究纳入了 2014 年 3 月至 2016 年 7 月期间接受手术治疗且随访 2 年的 53 例患者。其中 25 例行 MBA，28 例行 MB。采用美国矫形足踝协会（AOFAS）后足评分、足踝能力测量（FAAM）评分、活动范围（ROM）和视觉模拟评分（VAS）评估患者，采用距骨倾斜角（TTA）和距骨前向位移（ATT）评估机械稳定性。所有影像学结果均由 2 位骨科医生测量，3 天后重复测量。
MBA 组患者的平均年龄为 26.6±17.8 岁，MB 组为 28.1±19.4 岁，两组患者术前数据无统计学差异。组内术前与术后比较差异均有统计学意义。两组患者均取得了满意的效果，且在 1 年随访和最终随访时，VAS、FAAM、AOFAS、TTA 和 ATT 均有显著改善（P<0.05）。MBA 组在 FAAM 运动评分（87.1±5.4 分比 78.2±12.0 分，P=0.001）和总分（93.1±2.3 分比 90.5±5.1 分，P=0.027）方面的改善明显优于 MB 组，而其他结果两组间无显著差异。
对于慢性外侧踝关节不稳定患者，改良 Broström 修复术联合缝线带增强治疗效果更好，但仍需进一步研究。
