Kim Sung Hwan, Lee Sang Heon, Choi Seung Jin, Lee Young Koo
Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Bucheon, 14584, Korea.
BMC Musculoskelet Disord. 2025 Apr 21;26(1):383. doi: 10.1186/s12891-025-08546-7.
Ankle sprains are the most frequent musculoskeletal injury in sports. Patients reporting pain at the lateral malleolus tip following ankle sprains or sports activities frequently have separated ossicles, referred to as an os subfibulare (OSF). Commonly, small ossicles accompanied by chronic lateral ankle instability (CLAI) are treated with ossicle resection combined with the modified Broström operation (MBO). We compared the clinical and radiological results between groups in which a small OSF was or was not removed.
We retrospectively enrolled all patients with a small OSF who underwent arthroscopic MBO by one surgeon in one institution between 2015 and 2022. The study included skeletally mature patients who had an OSF among those who had MBO surgery and follow-up for at least 1 year. An ossicle was defined as small if the longitudinal diameter was < 5 mm on an anteroposterior plain radiograph.
There were no significant differences between the groups preoperatively or 6 or 12 months postoperatively. The radiographic findings did not differ significantly between groups.
When performing arthroscopic MBO on patients with CLAI, OSF ≤ 5 mm removal did not alter clinical or radiological outcomes, suggesting that excision may not be needed in asymptomatic patients. Considering the risks of the removal process, leaving it alone may be a treatment option.
Not applicable.
踝关节扭伤是体育运动中最常见的肌肉骨骼损伤。踝关节扭伤或体育活动后报告外踝尖疼痛的患者经常有分离的小骨，称为腓下骨（OSF）。通常，伴有慢性踝关节外侧不稳定（CLAI）的小骨采用小骨切除术联合改良布罗斯特罗姆手术（MBO）治疗。我们比较了切除或未切除小OSF的两组患者的临床和影像学结果。
我们回顾性纳入了2015年至2022年间在一家机构由一名外科医生进行关节镜下MBO手术的所有小OSF患者。该研究纳入了骨骼成熟的患者，这些患者在接受MBO手术且随访至少1年的人群中有OSF。如果前后位平片上小骨的纵径<5mm，则定义为小骨。
两组在术前、术后6个月或12个月时均无显著差异。两组之间的影像学表现无显著差异。
对CLAI患者进行关节镜下MBO手术时，切除≤5mm的OSF不会改变临床或影像学结果，这表明无症状患者可能不需要切除。考虑到切除过程的风险，不进行切除可能是一种治疗选择。
不适用。
