만성 외측 발목 불안정증의 변형 Broström 술식: 최소 절개 인대 파악 봉합술

Abstract

Approximately 20% to 30% of acute ankle sprains progress to chronic lateral ankle instability (CLAI), leading to recurrent sprains, pain, limitations in daily and sports activities, and potentially contributing to degenerative arthritis in the long term. The initial management primarily involves non-operative rehabilitation. On the other hand, surgical treatment is considered when mechanical instability is confirmed, and conservative treatment has failed. The surgical treatments for CLAI are broadly categorized into anatomical repair, anatomical reconstruction, non-anatomical reconstruction, and arthroscopic repair. The conventional open approach, such as the modified Broström procedure, typically employs ligament reattachment with cutting and suturing the elongated ligaments. In contrast, arthroscopic repair uses a ligament grasping technique, where the ligament is pulled and secured with sutures without cutting, with good results reported by reducing postoperative pain and shortening the rehabilitation period. The modified Broström procedure was improved by introducing the mini-open ligament grasping repair method, which involves a minimal incision and the ligament grasping technique. The mini-open ligament grasping repair technique was reported to maintain the benefits of open surgery while achieving outcomes similar to arthroscopic repair, particularly in reducing postoperative pain and shortening the rehabilitation period.