title: Intermediate and Long-Term Outcomes of the Modified Brostrom-Evans Procedure for Lateral Ankle Ligament Reconstruction.
abstract: Background This case series evaluated the clinical and functional outcomes of patients with lateral ankle instability treated with a primary modified Brostrom-Evans.Methods Nineteen patients who underwent the modified Brostrom-Evans procedure for lateral ankle instability with a minimum follow-up of 5 years were reviewed. Physical exams were performed and weight-bearing ankle radiographs taken at final follow-up. Clinical outcomes were evaluated using Short Form Health Survey (SF-36), Foot Function Index (FFI), and Visual Analog Scale (VAS) scores. Functional outcomes were assessed using a goniometer for ankle range of motion (ROM) and dynamometer for ankle strength compared to the non-operative extremity.Results Average age at time of surgery was 34 ± 11 years (range 17-58 years) and average follow-up was 8.7 ± 2.8 years (range 5.1-15.4 years). At final follow-up, average total SF-36 and FFI scores were 83 ± 18 and 11% ± 18%, respectively. Average VAS at rest was 1 ± 1 and during activities 2 ± 2. There were no significant differences in ankle eversion ROM or strength between operative and non-operative extremities. Ankle eversion strength in operative extremities was 91 ± 12% of non-operative ankles. Ankle ROM was similar in all planes except for a 41% decrease in ankle inversion in surgically treated extremities compared to the contralateral side (p = .01).Conclusions Patients treated with the modified Brostrom-Evans procedure for lateral ankle ligament reconstruction have minimal loss of peroneal strength, decreased inversion ROM, and no recurrent instability or progressive symptomatic subtalar arthritis requiring re-operation at long-term follow-up.
  
  
  METHODS
  Level IV: Retrospective case series.
authors.affiliation: OrthoCarolina Foot & Ankle Institute, Charlotte, North Carolina (ARH, WHD, RBA)Arkansas Specialty Orthopaedics, Little Rock, Arkansas (GTA) andyhsu1@gmail.com.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Hsu
authors.affiliation: OrthoCarolina Foot & Ankle Institute, Charlotte, North Carolina (ARH, WHD, RBA)Arkansas Specialty Orthopaedics, Little Rock, Arkansas (GTA).
authors.forename: G Troy
authors.initials: GT
authors.lastname: Ardoin
authors.affiliation: OrthoCarolina Foot & Ankle Institute, Charlotte, North Carolina (ARH, WHD, RBA)Arkansas Specialty Orthopaedics, Little Rock, Arkansas (GTA).
authors.forename: W Hodges
authors.initials: WH
authors.lastname: Davis
authors.affiliation: OrthoCarolina Foot & Ankle Institute, Charlotte, North Carolina (ARH, WHD, RBA)Arkansas Specialty Orthopaedics, Little Rock, Arkansas (GTA).
authors.forename: Robert B
authors.initials: RB
authors.lastname: Anderson
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D017844:Lateral Ligament, Ankle / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016474:Weight-Bearing; D055815:Young Adult
keywords: Brostrom; Evans; ankle instability; ankle ligament reconstruction; outcomes; split peroneus brevis