目的:观察关节镜下改良Brostrom-Gould术结合足印区重建治疗慢性踝关节外侧不稳的临床疗效和安全性。方法:2018年5月至2022年1月,采用关节镜下改良Brostrom-Gould术结合足印区重建治疗慢性踝关节外侧不稳患者30例。男14例,女16例。年龄1...目的:观察关节镜下改良Brostrom-Gould术结合足印区重建治疗慢性踝关节外侧不稳的临床疗效和安全性。方法:2018年5月至2022年1月,采用关节镜下改良Brostrom-Gould术结合足印区重建治疗慢性踝关节外侧不稳患者30例。男14例,女16例。年龄19~61岁,中位数36岁。合并距骨软骨损伤11例,合并跟腓韧带损伤1例。病程7~23个月,中位数12个月。记录术前及末次随访时患者踝关节疼痛视觉模拟量表(visual analog scale, VAS)评分、美国足与踝关节协会(American Orthopaedic Foot and Ankle Society, AOFAS)踝与后足评分及Karlsson评分,随访观察并发症发生情况。结果:所有患者均获随访,随访时间12~27个月,中位数18个月。切口均甲级愈合。踝关节疼痛VAS评分,术前(4.43±1.00)分、末次随访时(1.27±0.64)分;AOFAS踝与后足评分,术前(55.90±6.57)分、末次随访时(91.10±2.52)分;Karlsson评分,术前(42.13±1.95)分、末次随访时(80.10±3.20)分。均未发生踝关节感染、神经血管损伤等并发症。结论:关节镜下改良Brostrom-Gould术结合足印区重建治疗慢性踝关节外侧不稳,能够缓解踝关节疼痛、改善踝关节功能,且安全性高。展开更多
Background: The anterior talofibular ligament (ATFL) is the ligament most commonly injured during ankle sprains. Objective: The purpose of this investigation was to assess the sensitivity of Magnetic Resonance (MR) im...Background: The anterior talofibular ligament (ATFL) is the ligament most commonly injured during ankle sprains. Objective: The purpose of this investigation was to assess the sensitivity of Magnetic Resonance (MR) imaging for ATFL with open surgery, Brostrom-Gould surgical interventional considered the gold standard. Methods: A retrospective chart review using Operating Room (OR) and MR reports from April 2008-November 2009 led to a review of 137 charts, with 15 cases meeting the inclusion criteria. Results: The sensitivity for ATFL tears irrespective of extent of the tear was 93%. For full thickness ATFL tears, 10 were found to be positive on MR but 13 on OR with a sensitivity of 77%. Of the three missed cases, 2 were described as sprain injuries and the other normal using MRI. Conclusion: The recommendations for MR assessment of ankle injury include use of dedicated sequences and understanding the “pseudoband” concept. The two full thickness and two partial thickness tears on OR described as sprain injuries on MRI had a band of inflammatory granulation tissue. This tissue accounted for the appearance of the thick continuous band at MRI, the pseudoband. This study reaffirms the usefulness of MR in determining ATFL tears, aiding surgical decision making.展开更多
Peroneal tendon and retinacular pathology contributes to chronic lateral ankle instability. The “gold standard” surgical treatment for chronic lateral ankle instability has been the Brostrom-Gould procedure with its...Peroneal tendon and retinacular pathology contributes to chronic lateral ankle instability. The “gold standard” surgical treatment for chronic lateral ankle instability has been the Brostrom-Gould procedure with its modifications. An ankle arthroscopy is an adjuvant procedure to address any intra-articular pathology. We review our results of two study groups. The first group underwent an ankle arthroscopy and a Brostrom-Gould procedure. The second group (triad) underwent an ankle arthroscopy, the Brostrom-Gould procedure and excision of low lying peroneal muscle belly with tightening of the inferior peroneal retinaculum. The triad technique was performed on 97 patients and results compared to 71 ankle arthroscopies with the Brostrom-Gould procedure. The patients were contacted at a mean follow-up time of 30 months for postoperative ACFAS scores, VAS scores, and overall satisfaction. Patients were also asked to report incidence of ankle sprain recurrence. The average postoperative ACFAS hindfoot and ankle score was 92 for the triad group and 89 for the arthroscopic debridement and Brostrom-Gould group. The average overall satisfaction was 98% in the triad group and 91% in the scope and Brostrom group. There were 4 (4.3%) recurrences in the triad group and 12 (17.6%) in the Brostrom-Gould with scope group. Each group had a similar incidence of wound healing complications. Peroneal tendon and retinacular pathology contributes to continued ankle instability and pain. We believe that the triad procedure is superior to the Brostrom-Gould procedure.展开更多
文摘目的:观察关节镜下改良Brostrom-Gould术结合足印区重建治疗慢性踝关节外侧不稳的临床疗效和安全性。方法:2018年5月至2022年1月,采用关节镜下改良Brostrom-Gould术结合足印区重建治疗慢性踝关节外侧不稳患者30例。男14例,女16例。年龄19~61岁,中位数36岁。合并距骨软骨损伤11例,合并跟腓韧带损伤1例。病程7~23个月,中位数12个月。记录术前及末次随访时患者踝关节疼痛视觉模拟量表(visual analog scale, VAS)评分、美国足与踝关节协会(American Orthopaedic Foot and Ankle Society, AOFAS)踝与后足评分及Karlsson评分,随访观察并发症发生情况。结果:所有患者均获随访,随访时间12~27个月,中位数18个月。切口均甲级愈合。踝关节疼痛VAS评分,术前(4.43±1.00)分、末次随访时(1.27±0.64)分;AOFAS踝与后足评分,术前(55.90±6.57)分、末次随访时(91.10±2.52)分;Karlsson评分,术前(42.13±1.95)分、末次随访时(80.10±3.20)分。均未发生踝关节感染、神经血管损伤等并发症。结论:关节镜下改良Brostrom-Gould术结合足印区重建治疗慢性踝关节外侧不稳,能够缓解踝关节疼痛、改善踝关节功能,且安全性高。
文摘Background: The anterior talofibular ligament (ATFL) is the ligament most commonly injured during ankle sprains. Objective: The purpose of this investigation was to assess the sensitivity of Magnetic Resonance (MR) imaging for ATFL with open surgery, Brostrom-Gould surgical interventional considered the gold standard. Methods: A retrospective chart review using Operating Room (OR) and MR reports from April 2008-November 2009 led to a review of 137 charts, with 15 cases meeting the inclusion criteria. Results: The sensitivity for ATFL tears irrespective of extent of the tear was 93%. For full thickness ATFL tears, 10 were found to be positive on MR but 13 on OR with a sensitivity of 77%. Of the three missed cases, 2 were described as sprain injuries and the other normal using MRI. Conclusion: The recommendations for MR assessment of ankle injury include use of dedicated sequences and understanding the “pseudoband” concept. The two full thickness and two partial thickness tears on OR described as sprain injuries on MRI had a band of inflammatory granulation tissue. This tissue accounted for the appearance of the thick continuous band at MRI, the pseudoband. This study reaffirms the usefulness of MR in determining ATFL tears, aiding surgical decision making.
文摘Peroneal tendon and retinacular pathology contributes to chronic lateral ankle instability. The “gold standard” surgical treatment for chronic lateral ankle instability has been the Brostrom-Gould procedure with its modifications. An ankle arthroscopy is an adjuvant procedure to address any intra-articular pathology. We review our results of two study groups. The first group underwent an ankle arthroscopy and a Brostrom-Gould procedure. The second group (triad) underwent an ankle arthroscopy, the Brostrom-Gould procedure and excision of low lying peroneal muscle belly with tightening of the inferior peroneal retinaculum. The triad technique was performed on 97 patients and results compared to 71 ankle arthroscopies with the Brostrom-Gould procedure. The patients were contacted at a mean follow-up time of 30 months for postoperative ACFAS scores, VAS scores, and overall satisfaction. Patients were also asked to report incidence of ankle sprain recurrence. The average postoperative ACFAS hindfoot and ankle score was 92 for the triad group and 89 for the arthroscopic debridement and Brostrom-Gould group. The average overall satisfaction was 98% in the triad group and 91% in the scope and Brostrom group. There were 4 (4.3%) recurrences in the triad group and 12 (17.6%) in the Brostrom-Gould with scope group. Each group had a similar incidence of wound healing complications. Peroneal tendon and retinacular pathology contributes to continued ankle instability and pain. We believe that the triad procedure is superior to the Brostrom-Gould procedure.
