Treatment of Chronic Ankle Lateral Instability using Modified Brostrom Procedure

Jae Hoon Ahn; Young-Geun Lee; Se-Hyun Jung; Won-Sik Choy

doi:10.4055/jkoa.2007.42.1.91

Journal List > J Korean Orthop Assoc > v.42(1) > 1012745

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Ahn, Lee, Jung, and Choy: Treatment of Chronic Ankle Lateral Instability using Modified Brostrom Procedure

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(1): 91-97.

Published online: 28 February 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.1.91

Treatment of Chronic Ankle Lateral Instability using Modified Brostrom Procedure

Jae Hoon Ahn, M.D., Young-Geun Lee, M.D., Se-Hyun Jung, M.D., Won-Sik Choy, M.D.

Department of Orthopaedic Surgery, Eulji University College of Medicine, Daejeon, Korea.

Address reprint requests to Jae Hoon Ahn, M.D. Department of Orthopaedic Surgery, Eulji University College of Medicine, 1306, Dunsan-dong, Seo-gu, Daejon 302-799, Korea. Tel: +82.42-611-3279, 3280, Fax: +82.42-259-1289, jhahn@eulji.ac.kr

Abstract

Purpose

To analyze the results of modified Brostrom procedure for chronic ankle lateral instability.

Materials and Methods

Twenty six patients were followed up for more than 1 year after performing the modified Brostrom procedure. The mean age was 35.3 years, and the mean follow-up period was 2.4 years. Anterior and varus stress radiographs were taken in all cases, and a preoperative MRI was taken in 22 cases. Clinically, the Karlsson scale and Sefton grading were used. The effects of age, injury pattern and associated injury such as osteochondral fracture on the clinical results were analyzed.

Results

Radiologically the difference in anterior displacement between the affected side and contralateral side was 3.1 mm, and that of the varus tilt was 4.2°. At the last follow-up, the Karlsson scale had increased from preoperative 47.5 points to 90.3 points. There were 14 excellent, 8 good, 3 fair and 1 poor results according to the Sefton grading. The results were significantly worse in patients over 50 years of age. An osteochondral fracture or degenerative changes also lowered the level of patient satisfaction.

Conclusion

The modified Brostrom procedure appears to be a safe and highly satisfactory procedure. However, a more careful approach is needed for patients over 50 years of age or with associated degenerative changes.

Keywords: Ankle joint, Lateral instability, Modified Brostrom procedure

Figures and Tables

Fig. 1

Intraoperative photograph showing a lax calcaneofibular ligament (held with forecps) and a large Os subfibulare (black arrow).

Fig. 2

Ankle stress radiograph of an 18 year-old female patient showing varus instability of the right ankle and Os subfibulare.

Table 1

Patients' Data

Table 2

Factors affecting the Postoperative Results

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