Martin Kevin D, Andres Nolan N, Robinson William H
Evans Army Community Hospital, Ft Carson, CO, USA.
Rocky Vista University College of Osteopathic Medicine, Parker, CO, USA.
Foot Ankle Int. 2021 Feb;42(2):145-150. doi: 10.1177/1071100720959015. Epub 2020 Oct 5.
Immediately following a lateral ligament reconstruction of the ankle, the strength of the repair is far less than that of the native anterior talofibular ligament (ATFL). Additionally, early functional rehabilitation has been shown to increase laxity of the repair. We hypothesized that a Broström procedure augmented with a suture-tape construct would allow early functional rehabilitation while maintaining patient reported outcomes within a military population.
This study is a retrospective study of 93 consecutive patients with chronic lateral ankle instability that were treated with a Broström procedure augmented with a suture-tape construct. Subjects were evaluated at 2, 6, and 12 weeks postoperatively, with yearly satisfaction reviews. Demographics and functional outcomes including Foot and Ankle Disability Index (FADI), visual analog scale (VAS), satisfaction score, and clinical measures including single-leg hop and single-leg heel raise were recorded. Our patients included 75 males and 18 females with a mean age of 30 ± 7 (range, 19-51) years; our mean follow-up was 19 (range, 3-48) months.
The mean FADI score improved from 67 preoperatively to 87 and 90 at 6 and 12 weeks ( < .001), with 60 patients (65%) obtaining a score greater than 90. The mean VAS scores improved from 4.8 preoperatively to 1.4 and 1.3 at 6 and 12 weeks ( < .001). Eighty-two (96%) of the patients asked were able to complete a single-leg hop and single-leg heel raise at 6 weeks. The 12-, 24-, 36-, and 48-month satisfaction scores were 8.5, 9.8, 9.2, and 8.9, respectively. Demographics collected did not impact results.
This study suggests that a Broström procedure augmented with suture tape enabled early safe functional rehabilitation without subsequent failure. Our data also demonstrated a sustained high level of patient satisfaction while preventing reoccurrence within a high-demand military population.
Level IV, retrospective case series.
踝关节外侧韧带重建术后，修复部位的强度远低于天然距腓前韧带（ATFL）。此外，早期功能康复已被证明会增加修复部位的松弛度。我们假设，采用缝线带结构增强的布罗斯特伦手术（Broström procedure）能够实现早期功能康复，同时在军人人群中保持患者报告的治疗效果。
本研究是一项回顾性研究，对93例连续的慢性踝关节外侧不稳定患者采用缝线带结构增强的布罗斯特伦手术进行治疗。在术后2周、6周和12周对受试者进行评估，并每年进行满意度复查。记录人口统计学数据和功能结局，包括足踝残疾指数（FADI）、视觉模拟评分（VAS）、满意度评分，以及包括单腿跳跃和单腿提踵在内的临床指标。我们的患者包括75名男性和18名女性，平均年龄为30±7（范围19 - 51）岁；平均随访时间为19（范围3 - 48）个月。
FADI评分均值从术前的67分提高到术后6周和12周的87分和90分（P <.001），60例患者（65%）得分高于90分。VAS评分均值从术前的4.8分提高到术后6周和12周的1.4分和1.3分（P <.001）。82例（96%）接受询问的患者在术后6周能够完成单腿跳跃和单腿提踵。12个月、24个月、36个月和48个月的满意度评分分别为8.5、9.8、9.2和8.9。收集的人口统计学数据不影响结果。
本研究表明，采用缝线带增强的布罗斯特伦手术能够实现早期安全的功能康复，且不会出现后续失败情况。我们的数据还表明，在高需求的军人人群中，患者满意度持续保持在较高水平，同时预防了复发。
IV级，回顾性病例系列。
