No abstract

Objective To compare the clinical and radiological outcome between the modified Broström repair with augmentation using suture tape (MBA) and the modified Broström repair (MB) for patients with chronic lateral ankle instability. Methods A retrospective study was performed in Ningbo No. 6 Hospital. The study included 53 patients who underwent surgical treatment from March 2014 to July 2016 and were followed for 2 years. A total of 25 patients underwent modified Broström repair with augmentation using suture tape, and 28 patients were treated with modified Broström repair. Patients were evaluated using the American Orthopedic Foot and Ankle Scale (AOFAS) hindfoot scale, the Foot and Ankle Ability Measure (FAAM) score, range of motion (ROM), and the visual analogue scale (VAS). The talar tilt angle (TTA) and anterior talar translation (ATT) were used to evaluate the mechanical stability. All radiological outcomes were measured by two orthopaedic surgeons, with the measurements repeated 3 days later. Results The mean age of the patients was 26.6 ± 17.8 years in the MBA group and 28.1 ± 19.4 years in the MB group, and no statistical difference in preoperative data was found between two groups. There were significant differences before and after the operation within the groups. Both groups achieved satisfactory outcomes, and significant improvements (VAS, FAAM, AOFAS, TTA, and ATT) were observed between the 1‐year follow‐up and final follow‐up ( P < 0.05). The MBA group showed significant improvement in the FAAM Sport (87.1 ± 5.4 vs 78.2 ± 12.0, P = 0.001) and total scores (93.1 ± 2.3 vs 90.5 ± 5.1, P = 0.027) at the final follow‐up compared with the MB group, and for the other outcomes, there were no significant differences between the two groups. Conclusion The modified Broström repair with augmentation using suture tap for chronic lateral ankle instability achieves a better outcome; however, further research is necessary.

Purpose To analyze the current randomized controlled trials (RCTs) of dynamic fixations (DFs) and static fixations (SFs) in treating distal tibiofibular syndesmosis injuries (DTSIs). Methods The Cochrane Central Register of Controlled Trials, PubMed, and EMBASE were systematically searched according to the PRISMA guidelines to identify RCTs comparing the DFs and SFs for DTSIs. Included studies were assessed using the Cochrane Risk of Bias Tool. Postoperative functional scores, range of motion (ROM), complication rate, and incidence of reoperation were statistically analyzed using review manager software, and a p value of < 0.05 was considered statistically significant. Results Five RCTs with a total of 282 patients were included. Analysis revealed statistically significant differences in favor of DFs with regard to American Orthopaedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot score at a follow‐up less than 6 months (MD 5.29; 95% CI 0.99–9.59; p = 0.02; I2 = 0%) and at a follow‐up more than 2 years (MD 7.53; 95% CI 3.30–11.76; p = 0.0005; I2 = 0%), Olerud–Molander ankle (OMA) score at 1 year follow‐up (MD 4.62; 95% CI 0.91–8.32; p = 0.01; I2 = 14%), and overall postoperative complication rate (RR 0.22; 95% CI 0.07–0.77; p = 0.02; I2 = 73%). There was no significant difference between the DFs and SFs regarding ROM and incidence of reoperation. Conclusions The DF procedure leads to significantly improved functional scores as well as lower rate of overall postoperative complications when compared with SF procedure. On the basis of results of this meta‐analysis, the DF should be recommended for managing the DTSI. Level of evidence I.