Yoon Yeo Kwon, Park Kwang Hwan, Shim Dong Woo, Lee Wonwoo, Yoon Yong Hyun, Han Seung Hwan, Lee Jin Woo
Department of Orthopaedic Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Foot Ankle Int. 2025 Mar;46(3):324-331. doi: 10.1177/10711007241309914. Epub 2025 Jan 20.
Os subfibulare (OS) is commonly found in patients with chronic lateral ankle instability (CLAI). When performing lateral ligament reconstruction for CLAI, excision of a large OS can cause substantial lateral ligament defects making anatomic repair challenging. This study analyzed clinical and radiologic outcomes among patients who underwent osteosynthesis of the OS for chronic lateral ankle instability and a large OS.
28 ankles with CLAI and a large OS (≥10 mm) that underwent osteosynthesis of the OS between June 2007 and July 2021 were included in the study and followed for ≥24 months. Visual analog scale (VAS) for pain, Karlsson-Peterson ankle score, and Medical Outcomes Study Short Form Health Survey-36 physical component summary (SF-36 PCS), talar tilt angle, and anterior displacement of the talus were used to assess clinical and radiologic outcomes. All reoperations and complications were also evaluated.
The mean OS size was 15.4 mm (range, 12.2-21.0 mm). The mean follow-up period was 78.9 months (range, 24.0-177.0 months). Mean VAS score, Karlsson-Peterson ankle score, SF-36 PCS, talar tilt angle, and anterior displacement of the talus all improved significantly, from preoperative values of 5.3 ± 1.8, 38.4 ± 10.6, 45.6 ± 10.8 points, 11.1 ± 5.7 degrees, and 7.3 ± 1.9 mm, to 0.9 ± 1.4, 88.7 ± 12.6, 80.2 ± 12.3 points, 3.9 ± 2.0 degrees, and 4.8 ± 1.3 mm, respectively, by the last follow-up. The overall complication rate was 10.7% (3 ankles); the reoperation rate was 7.1% (2 ankles).
Osteosynthesis of the OS produced satisfactory outcomes in patients with CLAI and a large OS. This method may be a viable surgical option for patients with this condition.
腓下骨（OS）常见于慢性外侧踝关节不稳（CLAI）患者中。在为CLAI患者进行外侧韧带重建时，切除较大的OS会导致大量外侧韧带缺损，使解剖修复具有挑战性。本研究分析了因慢性外侧踝关节不稳和较大OS而接受OS接骨术的患者的临床和影像学结果。
纳入2007年6月至2021年7月间因CLAI和较大OS（≥10 mm）接受OS接骨术的28个踝关节，并进行≥24个月的随访。采用疼痛视觉模拟量表（VAS）、卡尔森-彼得森踝关节评分、医学结局研究简明健康调查-36身体成分汇总（SF-36 PCS）、距骨倾斜角和距骨前移来评估临床和影像学结果。还对所有再次手术和并发症进行了评估。
OS的平均大小为15.4 mm（范围为12.2 - 21.0 mm）。平均随访期为78.9个月（范围为24.0 - 177.0个月）。末次随访时，VAS评分、卡尔森-彼得森踝关节评分、SF-36 PCS、距骨倾斜角和距骨前移均较术前显著改善，术前值分别为5.3±1.8、38.4±10.6、45.6±10.8分、11.1±5.7度和7.3±1.9 mm，术后分别为0.9±1.4、88.7±12.6、80.2±12.3分、3.9±2.0度和4.8±1.3 mm。总体并发症发生率为10.7%（3个踝关节）；再次手术率为7.1%（2个踝关节）。
OS接骨术在CLAI和较大OS患者中产生了满意的结果。该方法可能是此类患者可行的手术选择。
