• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.201-207
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• 2003

Purpose: We reviewed the value of treatment for chronic lateral instability of theankle with arthroscopic procedure combined with Brostrom one. Material and Method: From May 2000 to June 2002, 18 patient with chronic lateral instability of the ankle with Modified Brostrom procedure and arthroscopic one. Mean follow-up period was 18 months. Result: Chronic lateral instability of the ankle almost had intraarticular pathology, such as osteophye, osteochondral lesion, So we could resolve intraarticular pathology by arthroscopic procedure during Brostrom one for lateral collateral ligament reconstruction. Conclusion: Modified Brostrom procedure and arthroscopic one are an excellent treating method for chronic lateral instability of the ankle which has intraarticular pathology.

• Journal of Korean Foot and Ankle Society
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• v.2 no.1
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• pp.6-12
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• 1998

Many surgical procedures have been described for the treatment of chronic lateral instability of the ankle. Tenodesis procedures using peroneus brevis tendon is traditionally common among them. Recently, the modified Brostrom anatomic procedure, that is, tightening the stretched out lateral ligaments to restore their norma] anatomy without the use of supplemental tissues and then suturing the lateral portion of the extensor retinaculum to the distal fibula over the ligament repair. has been gaining in popularity. We have reviewed 6 of 10 consecutive cases at an average of 17 months after modified Brostrom procedure. An excellent or good result was achieved in 5 cases, all of which had improved mechanical stability as measured radiographically. One case that had an unsatisfactory result was in patient who had had a previous Evans' operation. So, we believed that the modified Brostrom procedure is an excellent treating method for chronic lateral instability of the ankle.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.149-152
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• 2004

Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

• Journal of Korean Foot and Ankle Society
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• v.16 no.4
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• pp.241-246
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• 2012

Purpose: The purpose of our study was to perform a comparison of the outcomes of the modified Brostrom procedure using only a suture anchor compared with using a suture anchor with a pushlock anchor. Materials and Methods: This was a retrospective study of chronic lateral ankle instability that underwent a modified Brostrom procedure using a bioabsorbable suture anchor & a pushlock anchor, performed by a single surgeon. A total of 88 patients were enrolled in the study. The function of the patient's ankles were scored using the American Orthopaedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS) both preoperatively and postoperatively. Results: The difference in the overall means between the group A and group B was not statistically significant. But, the patient's satisfaction was better in the group B, and there were more complications in the group A. Conclusion: The technique presented here uses the modified Brostrom procedure with pushlock anchors to prevent the problems associated with subcutaneous knot irritation.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.283-287
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• 2013

Purpose: To evaluate the result of arthroscopic modified Brostrom procedure with suture anchor for chronic lateral ankle instability. Materials and Methods: Fifty-two patients with chronic lateral ankle instability were analyzed, who underwent arthroscopic modified Brostrom procedure between December 2010 and May 2012. Clinical evaluation was performed using AOFAS scroring and Sefton grading system. Results: The average AOFAS hind foot score increased from preoperative 61.9 to 88.8 at the last follow up. There were 35 excellent, 9 good, 4 fair, 4 poor results according to Sefton grading system. For one patient, lateral ankle instability recurred. Conclusion: Arthroscopic modified Brostrom procedure is considered to be an effective and satisfactory technique.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.251-255
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• 2002

Purpose: Chronic subtalar instability is not common and similar to chronic ankle instability and the incidence and cause chronic subtalar instability are not well known. Recently we have experienced chronic subtalar instability without chronic ankle instability which was treated with modified Brostrom procedures. Materials and Methods: The patient is 46 year old man who has suffered from left ankle sprain for 30 years and recently aggravated more than twice a day. On subtalar stress view, 14 degree angulation of subtalar joint was noted and on anterior drawer view, 8 mm anterior displacement of left ankle was seen. Results: In operation, there was no anterior talofibular ligament abnormility but calcaneofibular ligament loosening was found. Ligament reconstruction was performed using modified Brostrom procedure. At 12 months after operation, the patient complains no pain and no limit of motion and no instability. Conclusion: We experienced chronic subtalar instability without ankle instability treated with modified Brostrom procedures. No instability was found after treatment without complication.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.11-17
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• 2006

Purpose: To evaluate the clinical results of resection of os subfibulare and lateral ligament reattachment or modified Brostrom procedure in patients with symptomatic os subfibulare. Materials and Methods: This is a retrospective study on fourteen patients (14 ankles) who have symptoms associated with os subfibulare. Between August 1999 and July 2004, they underwent 4 resection of os subfibulare and lateral ligament reattachment for ankle pain due to os subfibulare or 10 resection of os subfibulare and modified Brostrom procedure available for ankle instability due to os subfibulare. Follow-up period is averaged for 17.6 months (12-24 months). Clinical results were graded according to the AOFAS clinical rating system. Results: Clinical results were rated as good in 4 ankles after resection of os subfibulare and lateral ligament reattachment, excellent in 5, good in 4, and fair in 1 ankle after the resection of os subfibulare and modified Brostrom procedure. In the last follow up period, 1 case of anterolateral ankle instability, 1 case of ankle pain and 1 case of inversion limitation were present postoperatively, but all symptoms were improved progressively. Conclusion: Resection of os subfibulare and modified Brostrom procedure is a good surgical technique for chronic ankle instability due to os subfibulare. But if just the ankle pain is present, resection of os subfibulare and lateral ligament reattachment is a sufficient procedure.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.69-77
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• 2011

Purpose: This study was retrospectively performed to compare the clinical outcomes of modified Brostrom procedures using the single suture anchor and the double suture anchor for chronic lateral ankle instability. Materials and Methods: Thirty-seven patients were followed up for more than 1 year after the modified Brostrom procedures using suture anchor. Single surgeon treated seventeen cases with single suture anchor and 20 cases with double suture anchor. The clinical evaluation was performed according to the Karlsson scale and Sefton grading system. Radiologic measurement of the talar tilt and anterior talar translation was performed through anterior and varus stress radiographs using Telos device. Results: The Karlsson scale had improved significantly from preoperative average of 45.2 points to 89.4 points in single suture anchor group, and from 46.4 points to 90.5 points in double suture anchor group. According to the Sefton grading system, 15 cases (88.2%) in single suture anchor group and 18 cases (90%) in double suture anchor group achieved satisfactory results. The talar tilt angle and anterior talar translation had improved significantly from preoperative average of $13.6^{\circ}$ and 8.6 mm to $5.4^{\circ}$ and 4.1 mm in single suture anchor group, from $14.1^{\circ}$ and 8.4mm to $3.9^{\circ}$ and 4 mm in double suture anchor group. Double suture anchor technique was significantly superior in postoperative talar tilt. Conclusion: Single and double suture anchor techniques produced similar clinical and functional outcomes except for talar tilt, which was significantly superior in double suture anchor group. Both modified Brostrom procedures using the single and double suture anchor appear to be effective treatment methods for chronic lateral ankle instability. Further evaluation of clinical outcomes and biomechanical studies in athletes are needed.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2007.04a
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• pp.10-11
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• 2007

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.108-114
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• 2014

Purpose: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. Materials and Methods: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. Results: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean $16.8^{\circ}$, 13.5 mm to $4.2^{\circ}$, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. Conclusion: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.