Abstract：
Purpose: There are various surgical interventions available for the management of Chronic lateral ankle instability (CLAI). The Broström-Gould procedure has gained widespread recognition among foot and ankle specialists for its favorable surgical outcomes. However, with advancements in anatomical understanding and medical technology, further enhancements to the effectiveness of the Gould procedure are warranted. This study introduces a all-inside modified \"outside-in\" Broström -Gould procedure as an alternative approach for addressing lateral ankle instability. Methods: From August 2020 to October 2022, 40 patients with lateral ankle instability who underwent arthroscopic repair of the modified \"outside-in\" Broström-Gould procedure were retrospectively analyzed. All patients received standard non-surgical treatment before surgery for more than 6 months without symptom relief. Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) and Karlsson-Peterson score were used to evaluate the postoperative effect. Results: All patients were followed up for (14.62 ± 2.04) months. One year after operation, all patients could walk normally, ankle instability sensation disappeared, varus stress test and anterior drawer test were negative. The VAS , AOFAS and Karlsson-Peterson scores of all patients were significantly better compared with those before operation, and the difference between before and after operation was statistically significant. Conclusions: The modified \"outside-in\" Broström-Gould procedure can effectively treat CLAI, which can obtain satisfactory results. The procedure is straightforward, the impact is minimal, and the aesthetics are pleasing.
摘要：
目的：有各种手术干预措施可用于治疗慢性踝关节外侧不稳定（CLAI）。Broström-Gould手术因其良好的手术效果而在足部和踝关节专家中获得了广泛认可。然而,随着解剖学理解和医疗技术的进步，有必要进一步增强古尔德程序的有效性。这项研究引入了一种全内部改良的“外在”Broström-Gould程序，作为解决踝关节外侧不稳定的替代方法。方法:回顾性分析2020年8月至2022年10月40例踝关节外侧不稳定患者行关节镜下改良的“外向内”Broström-Gould手术修复术。所有患者在手术前接受标准非手术治疗6个月以上，症状无缓解。采用视觉模拟评分法(VAS)、美国骨科足踝协会(AOFAS)和Karlsson-Peterson评分评价术后疗效。结果:所有患者均获随访(14.62±2.04)个月。手术一年后,所有患者都能正常行走，踝关节不稳定的感觉消失了，内翻压力试验和前抽屉试验均为阴性。VAS,所有患者的AOFAS和Karlsson-Peterson评分均明显优于术前,手术前后差异有统计学意义。结论:改良的“外在内”Broström-Gould术式能有效治疗CLAI,可以获得满意的结果。程序很简单，影响很小，美学令人愉悦。
