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前距腓韧带和跟腓韧带缝合增强术后成功恢复运动及日常活动

Successful Return to Sport and Daily Activities After Suture Augmentation of Both the Anterior Talofibular Ligament and Calcaneofibular Ligament.

作者信息

Ghasemi S Ali, Tallapaneni Jetha, Murray Benjamin C, Yin Clark, Raphael James, Vaupel Zachary, Grant Allan, Fortin Paul

机构信息

Department of Orthopaedic Surgery, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania, U.S.A.

Royal Oak Beaumont Department of Orthopaedic Surgery, Royal Oak, Michigan, U.S.A.

出版信息

Arthrosc Sports Med Rehabil. 2023 Aug 14;5(5):100762. doi: 10.1016/j.asmr.2023.100762. eCollection 2023 Oct.

Abstract

PURPOSE

To evaluate the return to sport and daily activities in addition to clinical outcomes after modification of the Brostöm repair, specifically using suture augmentation for concomitant fixation of both the anterior talofibular ligament and calcaneofibular ligament.

METHODS

Patients who had grade III ankle sprains and lateral ankle instability, all of whom failed supervised conservative management, were included. Patients underwent a modified Broström procedure consisting of suture augmentation for both the anterior talofibular ligament and calcaneofibular ligament. For clinical outcome evaluation, Foot and Ankle Ability Measure (FAAM) and Karlsson-Peterson Scoring System for Ankle Function questionnaires coupled with questions regarding time of return to sport and level of sports activity were used.

RESULTS

Thirty-one patients were included. The differences in preoperative and postoperative FAAM scores for both the Activities of Daily Living subscale and Sports subscale were significant ( < .001). The FAAM Activities of Daily Living score improved from an average of 46.06 preoperatively to 77.49 postoperatively ( < .001, 99% confidence interval, 26.4-36.4). The FAAM Sports score improved from an average of 4 preoperatively to 19.31 postoperatively ( < .001, 99% confidence interval, 11.6-19.0). For the Karlsson-Peterson Scoring System for Ankle Function, the surveyed population reported a mean of 82.74 points out of 100 post-op (standard deviation 20.14). The mean time to return to sport activity was 5.72 months. Mean follow-up time was 24.12 months.

CONCLUSIONS

This variant Broström procedure with suture anchors and augmentation of both the anterior talofibular ligament and calcaneofibular ligament was effective in helping patients return to their preinjury functionality level in both daily life and sports activity.

LEVEL OF CLINICAL EVIDENCE

Level IV, therapeutic case series.

摘要

目的

评估改良Brostöm修复术后的运动和日常活动恢复情况以及临床疗效,特别是使用缝线增强术同时固定距腓前韧带和跟腓韧带。

方法

纳入III级踝关节扭伤和踝关节外侧不稳定且均经监督下保守治疗失败的患者。患者接受改良的Brostöm手术,包括对距腓前韧带和跟腓韧带进行缝线增强术。对于临床疗效评估,使用足踝功能测量(FAAM)和踝关节功能Karlsson-Peterson评分系统问卷,并结合关于恢复运动时间和运动活动水平的问题。

结果

纳入31例患者。日常生活亚量表和运动亚量表术前和术后FAAM评分的差异均具有显著性(P <.001)。FAAM日常生活评分从术前平均46.06提高到术后77.49(P <.001,99%置信区间,26.4 - 36.4)。FAAM运动评分从术前平均4分提高到术后19.31分(P <.001,99%置信区间,11.6 - 19.0)。对于踝关节功能Karlsson-Peterson评分系统,调查人群术后平均得分为82.74分(满分100分,标准差20.14)。恢复运动活动的平均时间为5.72个月。平均随访时间为24.12个月。

结论

这种采用缝线锚钉并增强距腓前韧带和跟腓韧带的改良Brostöm手术有效地帮助患者在日常生活和运动活动中恢复到受伤前的功能水平。

临床证据水平

IV级,治疗性病例系列。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28ea/10450845/47ae3d9cf7e3/gr1.jpg

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