与单纯改良 Brostrom-Gould 修复术相比，内置支具增强术是否是慢性外侧韧带踝关节不稳定的金标准治疗方法？对功能结果和重返伤前活动的影响：回顾性分析。
Is Internal brace augmentation a gold standard treatment compared to isolated Modified Brostrom Gould repair for chronic lateral ligament ankle instability? Effect on functional outcome and Return to preinjury activity: A retrospective analysis.
机构信息
Department of Trauma and Orthopaedics, North Tees & Hartlepool University Hospital and NHS Foundation Trust, Stockton on Tees, United Kingdom.
Department of Trauma and Orthopaedics, North Tees & Hartlepool University Hospital and NHS Foundation Trust, Stockton on Tees, United Kingdom.
出版信息
Foot (Edinb). 2022 Mar;50:101865. doi: 10.1016/j.foot.2021.101865. Epub 2021 Sep 23.
INTRODUCTION
Modified Brostrom Gould (MBG) repair is widely accepted procedure for chronic lateral ankle instability (CLAI), but there are limitations with regards to strength of repair and risk of reinjury and complications. Internal brace has been recently used as augmentation of standard MBG repair. It provides stronger construct, facilitates early mobilisation and protects repaired ligament with minimal surgical morbidity. The aim of present study is to compare the outcome of MBG repair without and with Internal brace augmentation (IB) in CLAI.
METHODS
Retrospective analysis of 172 patients with CLAI who underwent MBG repair with or without IBA between November 2017 and October 2019. Patients were evaluated for Visual analogue scale (VAS), Manchester-oxford foot questionnaire (MOxFQ), Patients subjective satisfaction and return to preinjury activity level.
RESULTS
148 patients were included in the study with 87 in MBG group and 61 in IB group. The mean age, average injury-surgery interval and mean follow up duration was 40.6 ± 11.2 vs 37.5 ± 14.7 years, 13.1 ± 10.3 vs 14.1 ± 8 months and mean follow up duration of 24.2 ± 5.1 vs 20.7 ± 6.0 months respectively (p > 0.05). The mean time to return to preinjury activity level was significantly better in IB group compared to MBG group of 12.1 ± 2.3 vs 20.3 ± 3.9 weeks, p < 0.001. 55 (90.2%) patients in IB and 73 (83.7%) in MBG group return to preinjury activity level. Mean postoperative VAS score (1.9 ± 1.5 vs. 1.7 ± 1.4, p = 0.428), Mean MOxFQ score (19.7 ± 22.2 vs. 18.2 ± 15.4, p = 0.674) showed no significant difference between MBG and IB group respectively, at final follow up.
CONCLUSION
The use of IB augmentation with MBG repair showed significantly better outcome in terms of early rehabilitation and return to preinjury activity level compared to isolated MBG repair. The functional outcome and VAS score were better in IB group compared to MBG group with no significant difference.
LEVEL OF EVIDENCE
Level IV retrospective study.
简介
改良 Brostrom Gould（MBG）修复术被广泛应用于慢性外侧踝关节不稳定（CLAI），但该术式在修复强度、再损伤风险和并发症方面存在局限性。最近，内置支具已被用作 MBG 修复的增强物。它提供了更强的结构，促进早期活动，并以最小的手术发病率保护修复的韧带。本研究旨在比较 CLAI 中 MBG 修复术与内置支具增强（IB）的治疗效果。
方法
回顾性分析了 2017 年 11 月至 2019 年 10 月期间接受 MBG 修复术联合或不联合 IBA 的 172 例 CLAI 患者。采用视觉模拟评分（VAS）、曼彻斯特-牛津足部问卷（MOxFQ）、患者主观满意度和重返术前活动水平评估患者的疗效。
结果
共有 148 例患者纳入本研究，MBG 组 87 例，IB 组 61 例。两组的平均年龄、平均损伤-手术间隔和平均随访时间分别为 40.6±11.2 岁比 37.5±14.7 岁，13.1±10.3 月比 14.1±8 月，平均随访时间分别为 24.2±5.1 月比 20.7±6.0 月（p＞0.05）。IB 组的平均重返术前活动水平时间显著优于 MBG 组，分别为 12.1±2.3 周比 20.3±3.9 周，p＜0.001。IB 组 55（90.2%）例和 MBG 组 73（83.7%）例患者重返术前活动水平。MBG 组和 IB 组的平均术后 VAS 评分（1.9±1.5 比 1.7±1.4，p=0.428）和 MOxFQ 评分（19.7±22.2 比 18.2±15.4，p=0.674）在末次随访时无显著差异。
结论
与单独的 MBG 修复术相比，MBG 修复联合内置支具增强术在康复和重返术前活动水平方面有显著更好的结果。与 MBG 组相比，IB 组的功能结果和 VAS 评分更好，但无显著差异。
证据等级
IV 级回顾性研究。
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