Introduction: Ankle sprains affect 200'000 persons/year in Switzerland.
Most incidences are successfully treated by conservative measures
but 20% require reconstruction for symptomatic chronic lateral
ankle instability. This study evaluates the functional outcome after a
modified Broström-Gould technique as measured by different clinical
scores and compares the functional outcome of this technique with
other surgical treatments of ankle instability.
Methods: This retrospective cohort study evaluates 47 patients who
underwent a modified Broström-Gould procedure using suture anchors
to refix the lateral ankle capsuloligamentary structures at our institution
from 2005 to 2009 with a minimum follow-up of one year (13-72 Mo).
All patients were operated by one single surgeon and evaluated by an
independent examiner. The function was assessed using 4 scores
including: the AOFAS (American Orthopaedic Foot and Ankle Society's
Score) hindfoot score; the FAAM (Foot and Ankle Ability Measurement);
the CAIT (Cumberland Ankle Instability Tool); the CAIS (Chronic
Ankle Instability Scale).
Results: Six patients were excluded leaving 41 patients for examination.
34 patients (83%) thought that their ankle was more stable after
the surgery, 7 (17%) did not feel any difference. 27 patients were very
satisfied, 11 satisfied and 3 not satisfied. Reasons for non satisfaction
included persistent instability and pain. Ankle mobility returned to
normal in 93% of patients. Five patients had transcient hypoesthesy in
the area of the superficial peroneal nerve. One patient suffered from a
superficial infection treated successfully by local measures. 80% had
the perception of a normal ankle, 20% thought to be below normal.
At follow-up the AOFAS was 89/100 (37-100), the FAAM 85/100%
(35-100%), the CAIT 20/30 (5-30), and the CAIS 74/100% (27-100%).
Conclusions: The modified Broström-Gould procedure, which belongs
to the anatomic ankle stabilizations is relatively simple and offers good
outcome that satisfied 93% of the patients in the present study. No
active stabilisator is sacrificed. Preservation of the ankle mobility is
better and the complication rate is lower than after non-anatomical
procedures described in the literature. The CAIT appeared as the most
severe score compared to the other scales used in our study.