Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD.
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD.
J Foot Ankle Surg. 2022 Mar-Apr;61(2):390-395. doi: 10.1053/j.jfas.2021.09.027. Epub 2021 Oct 16.
The Modified Broström has become the gold standard for operative management of chronic lateral ankle instability. Despite overall good clinical outcomes with this procedure, recent biomechanical data have called into question the strength and durability of this technique. Accordingly, the addition of suture tape to the Modified Broström construct has been described in an attempt to more closely recreate the natural biomechanical properties of the ankle lateral ligament complex. We performed a systematic review of the literature was using PubMed, Embase, and CINAHL to identify English-language articles from 2009 to present discussing outcomes with the augmented Modified Broström technique. A total of 4 studies (2 retrospective cohort studies, 2 case series) involving 156 patients with Modified Broström with augmentation met inclusion criteria. Average follow-up time was 13.8 months. Of the 3 studies reporting patient-reported outcome measures both pre- and postoperatively, there was a significant improvement in all measures (p < .05). Two studies compared the Modified Broström directly with and without augmentation, one of which found a statistically significant difference in the Foot and Ankle Ability Measure in favor of the augmentation group (93.1 vs 90.5, p = .027), while American Orthopaedic Foot and Ankle Society score was not significantly different (p > .05) between the 2 procedures across studies. There were no significant differences in complications between techniques. Modified Broström with suture tape augmentation for chronic lateral ankle instability can produce good short-term clinical outcomes with few complications, comparable to the Modified Broström alone.
改良 Broström 术已成为慢性外侧踝关节不稳定手术治疗的金标准。尽管该手术总体上具有良好的临床效果，但最近的生物力学数据对该技术的强度和耐久性提出了质疑。因此，在改良 Broström 结构中添加缝线带已被描述，以试图更接近地重建踝关节外侧韧带复合体的自然生物力学特性。我们使用 PubMed、Embase 和 CINAHL 进行了系统的文献回顾，以确定从 2009 年至今讨论改良 Broström 增强技术结果的英文文章。共有 4 项研究（2 项回顾性队列研究，2 项病例系列研究）符合纳入标准，共纳入 156 例接受改良 Broström 增强术的患者。平均随访时间为 13.8 个月。在报告术前和术后患者报告结局测量值的 3 项研究中，所有测量值均显著改善（p<0.05）。有 2 项研究直接比较了改良 Broström 术与改良 Broström 增强术，其中 1 项研究发现改良 Broström 增强术在足踝能力测量方面具有统计学意义（93.1 对 90.5，p=0.027），而美国矫形足踝协会评分在 2 项研究中在两种术式之间没有显著差异（p>0.05）。两种技术的并发症无显著差异。慢性外侧踝关节不稳定的改良 Broström 术加缝线带增强术可产生良好的短期临床效果，并发症少，与单独的改良 Broström 术相当。
