Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, South Korea; Department of Orthopaedic Surgery, Chungbuk National University Hospital, Cheongju, South Korea.
Department of Orthopaedic Surgery, Chungbuk National University Hospital, Cheongju, South Korea.
J Foot Ankle Surg. 2022 May-Jun;61(3):577-582. doi: 10.1053/j.jfas.2021.10.012. Epub 2021 Oct 22.
Residual functional ankle instability regardless of the restoration of mechanical stability after the lateral ligament repair or reconstruction can cause recurrent sprain. The purpose of this study was to identify the sequential changes of joint-position sense, peroneal strength, postural control, and functional performance ability after the modified Broström procedure (MBP) for chronic ankle instability. A total of 46 patients (46 ankles) underwent the MBP for chronic ankle instability were eligible for this study and were followed for 1 year postoperatively. The changes of joint-position sense and peroneal strength were periodically evaluated with an isokinetic dynamometer. Postural control ability was evaluated using a one-leg stance test with eyes closed. The functional performance ability examination comprised a one-leg hop test, a 6-meter hop test, and a cross 3-meter hop test. The error in joint-position sense significantly improved from a mean 4.3º to 2.8º (p < .001). Peak torque for eversion significantly improved from a mean 18.2 Nm to 21.2 Nm (p = .024). Balance retention time significantly improved from a mean 4.7 seconds to 6.4 seconds (p < .001). Among the functional performance tests, only the one-leg hop test showed a significant improvement postoperatively (p = .031). At 1 year postoperatively, the recovery ratios compared to the unaffected ankle were 67.9% in joint-position sense (p < .001), 86.9% in peroneal strength (p = .012), and 74.4% in postural control (p < .001) with significant side-to-side differences. Although joint-position sense, peroneal strength, postural control, and functional performance ability were significantly improved after the MBP, recovery ratios compared to the unaffected ankle were insufficient up to 1 year postoperatively.
尽管外侧副韧带修复或重建后机械稳定性得到恢复,但残余的功能性踝关节不稳定仍可导致反复扭伤。本研究旨在确定改良 Broström 手术(MBP)治疗慢性踝关节不稳定后关节位置觉、腓骨肌力量、姿势控制和功能表现能力的顺序变化。共有 46 名(46 个踝关节)接受 MBP 治疗慢性踝关节不稳定的患者符合本研究条件,并在术后 1 年进行了随访。使用等速测力计定期评估关节位置觉和腓骨肌力量的变化。使用闭眼单腿站立测试评估姿势控制能力。功能表现能力检查包括单腿跳跃测试、6 米跳跃测试和交叉 3 米跳跃测试。关节位置觉的误差从平均 4.3°显著改善至 2.8°(p<0.001)。外翻峰值扭矩从平均 18.2 Nm 显著改善至 21.2 Nm(p=0.024)。平衡保留时间从平均 4.7 秒显著改善至 6.4 秒(p<0.001)。在功能表现测试中,只有单腿跳跃测试在术后显示出显著改善(p=0.031)。术后 1 年,与未受影响的踝关节相比,关节位置觉的恢复率为 67.9%(p<0.001),腓骨肌力量为 86.9%(p=0.012),姿势控制为 74.4%(p<0.001),存在显著的侧间差异。尽管 MBP 治疗后关节位置觉、腓骨肌力量、姿势控制和功能表现能力均显著改善,但与未受影响的踝关节相比,术后 1 年的恢复率仍不足。