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A Modified Broström Repair with Transosseous Fixation for Chronic Ankle Instability: A Midterm Followup Study in Soldiers

Overview
Journal Indian J Orthop
Publisher Springer Nature
Specialty Orthopedics
Date 2018 Jun 12
PMID 29887635
Citations 3
Authors
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Abstract

Background: Various surgical techniques are available to reduce chronic instability of the lateral ankle ligament complex. The most effective method for these procedures remains controversial. This report presents a surgical technique that is similar to the Broström procedure and uses a modified, nonaugmented repair technique.

Materials And Methods: 38 soldiers with a history of chronic lateral ankle instability and poor ankle function underwent plication of the anterior talofibular ligament-lateral capsule complex with transosseous fixation of the calcaneofibular ligament through a fibular bone tunnel between 2004 and 2007. This study included 33 men and 5 women with a mean age of 25.6 years (range 18-36 years) at the time of surgery. Each patient was confirmed to have a history of chronic lateral ankle instability after an inversion injury, and symptoms had been noted for at least 1 year. The patients were followed up with stress radiographs, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional score, and the Sefton assessment system. The mean followup period was 77.6 months (range 66-89 months).

Results: At the last evaluation, the talar tilt reduced from an average of 13.9° ± 2.4° before surgery to 3.8° ± 1.8° after surgery, and anterior drawer displacement reduced from 9.6 ± 2.9 mm to 2.3 ± 1.6 mm. The mean AOFAS ankle-hindfoot scale score for functional stability increased from 71.6 ± 4.0 points preoperatively to 95.6 ± 4.0 points postoperatively. As evaluated by the Sefton assessment system, 36 patients (95%) reported an excellent or good functional outcome. All patients resumed normal daily activities and active military duty after the surgery.

Conclusion: The procedure described here could be considered a viable alternative option to anatomic reconstruction such as the modified Broström procedure and might be appropriate for the general population.

Citing Articles

Chronic Lateral Ankle Instability in Highly Active Patients: A Treatment Algorithm Based on the Arthroscopic Assessment of the Calcaneofibular Ligament.

Triantafyllopoulos I, Economopoulos D, Panagopoulos A, van Niekerk L Cureus. 2021; 13(4):e14310.

PMID: 33968520 PMC: 8099009. DOI: 10.7759/cureus.14310.


[A comparative study of all-arthroscopic technique and modified open Broström technique in repair of anterior talofibular ligament with anchors].

Yi G, Fu S, Yang J, Wang G, Liu Y, Guo X Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019; 33(12):1503-1509.

PMID: 31823548 PMC: 8355784. DOI: 10.7507/1002-1892.201905072.


Complex Hindfoot and Ankle Trauma: The Management Status in 2018.

Dhillon M Indian J Orthop. 2018; 52(3):217-219.

PMID: 29887622 PMC: 5961257. DOI: 10.4103/ortho.IJOrtho_216_18.

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