Incidence and Cost of Ankle Sprains in United States Emergency Departments

Outcomes Following Modified Broström for Chronic Lateral Ankle Instability With and Without Peroneal Tendon Exploration

BACKGROUND

It is not known how peroneal tendon exploration influences results after modified Broström for lateral ankle instability. We propose peroneal exploration at the time of modified Broström will have similar outcomes as no peroneal exploration.

METHODS

A retrospective analysis was performed of patients undergoing modified Broström with and without peroneal exploration. Foot and Ankle Outcome scores and data regarding military retention were gathered and compared.

RESULTS

Seventeen patients were identified in the modified Broström only cohort and 24 in the peroneal exploration cohort. Patients had mean follow-up of 5 years in both cohorts. The mean FAOS in the modified Broström only cohort was 68 and 72 in the cohort with peroneal exploration (P = .541). When each FAOS subcategory was analyzed, no difference was identified in any subcategory. Eight of 17 patients (47%) in the modified Broström only cohort remained active duty compared with 8 of 24 patients (33%) in the modified Broström with peroneal exploration cohort (P = .518). One patient medically discharged in the modified Broström only cohort versus 6 in peroneal exploration cohort (P = .109). Overall satisfaction with the procedure was 12 of 17 (71%) in the modified Broström only cohort and 19 of 24 (79%) in the peroneal exploration cohort (P = .529).

CONCLUSIONS

No significant difference was identified between patients undergoing modified Broström alone or modified Broström with peroneal exploration. There was no significant difference in return to duty, medical discharge or patient satisfaction.

LEVELS OF EVIDENCE

Level III: retrospective case-control study with prospectively collected data.

Bröstrom Repair Review

Since its introduction in 1966, the Bröstrom repair has been the workhorse for the treatment of chronic ankle instability. The procedure has expanded with the advent of arthroscopy, ultrasound, and other techniques. Because chronic ankle sprains/instability pose a barrier to athletes who perform high-level activities for a living, discussions concerning postoperative recovery and return to play criteria are important. Here we present an update on the Bröstrom-Gould procedure from preoperative management to return to play.Level of Evidence: Level V.