족관절 외측의 만성 불안정성에 Broström 술식과 Suture Tape을 이용한 보강술 후 조기에 시행한 등자보호대 착용 및 체중부하 보행
Early Unrestricted Weight-Bearing in a Stirrup Brace Following the Broström Procedure with Suture Tape for Chronic Lateral Ankle Instability
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초록
Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Broström procedure with su- ture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Broström procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, includ- ing American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS de- creased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demon- strated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion: Early unrestricted weight-bearing in a stirrup brace following the Broström procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.
Abstract
Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Broström procedure with su- ture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Broström procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, includ- ing American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS de- creased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demon- strated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion: Early unrestricted weight-bearing in a stirrup brace following the Broström procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.
참고문헌 (24)
- Gerstner Garces JB, "Chronic ankle instability", Foot Ankle Clin, 17, pp.389~398 (2012)[DOI]
- Hølmer P, "Epidemiology of sprains in the lateral ankle and foot", Foot Ankle Int, 15, pp.72~74 (1994)[DOI]
- Harrington KD, "Degenerative arthritis of the ankle secondary to long-standing lateral ligament instability", J Bone Joint Surg Am, 61, pp.354~361 (1979)
- Karlsson J, "Subtalar instability of the foot. A review and results after surgical treatment", Scand J Med Sci Sports, 8, pp.191~197 (1998)[DOI]
- Valderrabano V, "Ligamentous posttraumatic ankle osteoarthritis", Am J Sports Med, 34, pp.612~620 (2006)[DOI]
- Aydogan U, "Extensor retinaculum augmentation reinforces anterior talofibular ligament repair", Clin Orthop Relat Res, 442, pp.210~215 (2006)[DOI]
- Broström L, "Sprained ankles. VI. Surgical treatment of"chronic"ligament ruptures", Acta Chir Scand, 132, pp.551~565 (1966)
- Cho BK, "A ligament reattachment technique for high-demand athletes with chronic ankle instability", J Foot Ankle Surg, 54, pp.7~12 (2015)[DOI]
- Gould N, "Early and late repair of lateral ligament of the ankle", Foot Ankle, 1, pp.84~89 (1980)[DOI]
- Maffulli N, "Isolated anterior talofibular ligament Broström repair for chronic lateral ankle instability : 9-year follow-up", Am J Sports Med, 41, pp.858~864 (2013)[DOI]
- Kirk KL, "ATFL elongation after Brostrom procedure : a biomechanical investigation", Foot Ankle Int, 29, pp.1126~1130 (2008)[DOI]
- Waldrop NE 3rd, "Anatomic suture anchor versus the Broström technique for anterior talofibular ligament repair : a biomechanical comparison", Am J Sports Med, 40, pp.2590~2596 (2012)[DOI]
- Keene DJ, "Early ankle movement versus immobilization in the postoperative management of ankle fracture in adults : a systematic review and meta-analysis", J Orthop Sports Phys Ther, 44, pp.690~701 (2014)[DOI]
- Petrera M, "Short-to medium-term outcomes after a modified Broström repair for lateral ankle instability with immediate postoperative weightbearing", Am J Sports Med, 42, pp.1542~1548 (2014)[DOI]
- Hermanns C, "Review of variability in rehabilitation protocols after lateral ankle ligament surgery", Kans J Med, 13, pp.152~159 (2020)[DOI]
- Coetzee JC, "Functional results of open Broström ankle ligament repair augmented with a suture tape", Foot Ankle Int, 39, pp.304~310 (2018)[DOI]
- Jeong BO, "Feasibility and outcome of inferior extensor retinaculum reinforcement in modified Broström procedures", Foot Ankle Int, 35, pp.1137~1142 (2014)[DOI]
- Dalmau-Pastor M, "X-shaped inferior extensor retinaculum and its doubtful use in the Bröstrom-Gould procedure", Knee Surg Sports Traumatol Arthrosc, 26, pp.2171~2176 (2018)[DOI]
- Kubiak EN, "Early weight bearing after lower extremity fractures in adults", J Am Acad Orthop Surg, 21, pp.727~738 (2013)[DOI]
- El-Akkawi AI, "Effect of early versus late weightbearing in conservatively treated acute Achilles tendon rupture : a meta-analysis", J Foot Ankle Surg, 57, pp.346~352 (2018)[DOI]
- Karlsson J, "Lateral instability of the ankle treated by the Evans procedure. A long-term clinical and radiological follow-up", J Bone Joint Surg Br, 70, pp.476~480 (1988)[DOI]
- Lundeen GA, "Immediate unrestricted weightbearing with simple stirrup brace following single anchor lateral ankle ligament stabilization", Foot Ankle Spec, 15, pp.456~463 (2022)[DOI]
- Martin KD, "Suture tape augmented Broström procedure and early accelerated rehabilitation", Foot Ankle Int, 42, pp.145~150 (2021)[DOI]
- Mackay GM, "A review of ligament augmentation with the InternalBraceTM : the surgical principle is described for the lateral ankle ligament and ACL repair in particular, and a comprehensive review of other surgical applications and techniques is presented", Surg Technol Int, 26, pp.239~255 (2015)