Broström ankle ligament repair augmented with suture tape : Results of magnetic resonance imaging evaluation.

IF 1.9 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Wiener Klinische Wochenschrift Pub Date : 2024-10-01 Epub Date: 2024-05-14 DOI:10.1007/s00508-024-02361-1

Florian Wenzel-Schwarz, Ulrike Wittig, Elena Nemecek, Rudolf Ganger, Till Bader, Wolfgang Huf, Reinhard Schuh

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引用次数: 0

Abstract

Background: The Broström procedure is an established procedure in cases of primary lateral ankle ligament repair (LALR). To improve postoperative stability an augmentation device, InternalBrace™ (Arthrex, Naples, FL) has been introduced. This study evaluates remodelling of the anterior talofibular ligament (ATFL) in patients undergoing a tape augmented Broström technique as well as clinical outcomes.

Methods: In this study 32 patients with chronic lateral ankle instability (CLAI) receiving augmented LALR were included. Clinical outcomes were evaluated at a one-time postoperative visit between 12 and 18 months. A 3 T magnetic resonance imaging (MRI) was done to evaluate the morphology of the ATFL. Statistical analysis was completed with the free software and environment R version 3.6.3 (Bell Laboratories, Murray Hill, NJ, USA) and P-values < 0.05 were considered statistically significant.

Results: The mean follow-up time was 15.3 ± 1.8 months with a return to sport time of 4.0 ± 2.4 months. The average AOFAS (American Orthopaedic Foot and Ankle Society Score) score was 94.4 ± 7.2, the FAOS (Foot and Ankle Outcome Score) demonstrated 87.3 ± 10.4 points and the FFI (Foot Function Index - 2 scores (pain and function score)) was 22.9 ± 20.1 and 15.4 ± 10.4, respectively. The MRI findings demonstrated an average length of the ATFL of 18.6 ± 4.3 mm and the width was 3.6 ± 0.9 mm. A clear differentiation between the ATFL and the augmentation device could be shown in 28 cases. The Fisher's exact test could not depict a significant correlation between the presence of a bone marrow edema and the tension of the augmentation device with a level of significance of α = 0.05.

Conclusion: An anatomical healing tendency of the ligament repair and good integrity of the augmentation device could be shown based on MRI findings. The lateral ligament repair augmented with suture tape is an effective and safe procedure regarding surgical treatment in chronic lateral ankle instability producing good clinical outcome.

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用缝合带增强布罗斯特伦踝关节韧带修复术：磁共振成像评估结果。

背景：Broström手术是一种成熟的外侧踝关节韧带修复术（LALR）。为了提高术后稳定性，一种名为 InternalBrace™ （Arthrex，佛罗里达州那不勒斯市）的增强装置已经问世。本研究评估了接受带式增强 Broström 技术的患者距前胫腓韧带（ATFL）的重塑情况以及临床效果：本研究纳入了 32 名接受增强型 LALR 的慢性外侧踝关节不稳定（CLAI）患者。临床结果在术后 12 至 18 个月之间进行一次性评估。3 T 磁共振成像（MRI）用于评估 ATFL 的形态。统计分析使用免费软件和环境 R 3.6.3 版（Bell Laboratories, Murray Hill, NJ, USA）完成，P 值为结果：平均随访时间为 15.3 ± 1.8 个月，恢复运动时间为 4.0 ± 2.4 个月。平均 AOFAS（美国骨科足踝协会评分）为 94.4 ± 7.2 分，FAOS（足踝结果评分）为 87.3 ± 10.4 分，FFI（足部功能指数 - 2 评分（疼痛和功能评分））分别为 22.9 ± 20.1 分和 15.4 ± 10.4 分。核磁共振成像结果显示，ATFL的平均长度为（18.6 ± 4.3）毫米，宽度为（3.6 ± 0.9）毫米。有 28 例患者的 ATFL 和增强装置之间有明显的区别。在α = 0.05的显著性水平下，费雪精确检验无法显示骨髓水肿的存在与增强装置的张力之间存在显著相关性：磁共振成像结果显示，韧带修复的解剖学愈合趋势和增强装置的良好完整性。在慢性外侧踝关节不稳的手术治疗中，用缝合带增强外侧韧带修复术是一种有效而安全的方法，能产生良好的临床效果。

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来源期刊

Wiener Klinische Wochenschrift 医学-医学：内科

CiteScore

4.70

自引率

3.80%

发文量

110

审稿时长

4-8 weeks

期刊介绍： The Wiener klinische Wochenschrift - The Central European Journal of Medicine - is an international scientific medical journal covering the entire spectrum of clinical medicine and related areas such as ethics in medicine, public health and the history of medicine. In addition to original articles, the Journal features editorials and leading articles on newly emerging topics, review articles, case reports and a broad range of special articles. Experimental material will be considered for publication if it is directly relevant to clinical medicine. The number of international contributions has been steadily increasing. Consequently, the international reputation of the journal has grown in the past several years. Founded in 1888, the Wiener klinische Wochenschrift - The Central European Journal of Medicine - is certainly one of the most prestigious medical journals in the world and takes pride in having been the first publisher of landmarks in medicine.