Abstract:
Background This case series evaluated the clinical and functional outcomes of patients with lateral ankle instability treated with a primary modified Brostrom-Evans.Methods Nineteen patients who underwent the modified Brostrom-Evans procedure for lateral ankle instability with a minimum follow-up of 5 years were reviewed. Physical exams were performed and weight-bearing ankle radiographs taken at final follow-up. Clinical outcomes were evaluated using Short Form Health Survey (SF-36), Foot Function Index (FFI), and Visual Analog Scale (VAS) scores. Functional outcomes were assessed using a goniometer for ankle range of motion (ROM) and dynamometer for ankle strength compared to the non-operative extremity.Results Average age at time of surgery was 34 ± 11 years (range 17-58 years) and average follow-up was 8.7 ± 2.8 years (range 5.1-15.4 years). At final follow-up, average total SF-36 and FFI scores were 83 ± 18 and 11% ± 18%, respectively. Average VAS at rest was 1 ± 1 and during activities 2 ± 2. There were no significant differences in ankle eversion ROM or strength between operative and non-operative extremities. Ankle eversion strength in operative extremities was 91 ± 12% of non-operative ankles. Ankle ROM was similar in all planes except for a 41% decrease in ankle inversion in surgically treated extremities compared to the contralateral side (p = .01).Conclusions Patients treated with the modified Brostrom-Evans procedure for lateral ankle ligament reconstruction have minimal loss of peroneal strength, decreased inversion ROM, and no recurrent instability or progressive symptomatic subtalar arthritis requiring re-operation at long-term follow-up.
METHODS: Level IV: Retrospective case series.
摘要:
背景本病例系列评估了原发性改良Brostrom-Evans治疗的踝关节外侧不稳定患者的临床和功能结果。方法对19例接受改良Brostrom-Evans手术治疗的踝关节外侧不稳定患者进行最少5年随访。在最后的随访中进行了身体检查并拍摄了负重踝关节的X光片。使用简短的健康调查(SF-36)评估临床结果,脚函数指数(FFI),和视觉模拟量表(VAS)评分。与非手术肢体相比,使用角度计评估踝关节运动范围(ROM)和测力计评估踝关节强度。结果手术平均年龄为34±11岁(17-58岁),平均随访时间为8.7±2.8年(5.1-15.4岁)。在最后的后续行动中,平均SF-36和FFI总分分别为83±18和11%±18%,分别。静息时的平均VAS为1±1,活动期间为2±2。手术和非手术四肢之间的踝关节外翻ROM或强度没有显着差异。手术四肢的脚踝外翻强度为非手术脚踝的91±12%。除了与对侧相比,经手术治疗的四肢的踝关节内翻减少了41%外,所有平面的踝关节ROM相似(p=0.01)。结论改良Brostrom-Evans手术重建踝关节外侧韧带的患者腓骨强度损失最小,减少反转ROM,在长期随访中,没有复发性不稳定或进行性症状性距下关节炎需要再次手术。
方法:IV级:回顾性病例系列。