Intermediate and Long-Term Outcomes of the Modified Brostrom-Evans Procedure for Lateral Ankle Ligament Reconstruction

Foot Ankle Spec. 2016 Apr;9(2):131-9. doi: 10.1177/1938640015609970. Epub 2015 Oct 12.

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.

Levels of evidence: Level IV: Retrospective case series.

Keywords: Brostrom; Evans; ankle instability; ankle ligament reconstruction; outcomes; split peroneus brevis.

MeSH terms

  • Adolescent
  • Adult
  • Ankle Injuries / complications
  • Ankle Injuries / physiopathology
  • Ankle Injuries / surgery*
  • Ankle Joint / physiopathology
  • Ankle Joint / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Instability / etiology
  • Joint Instability / physiopathology
  • Joint Instability / surgery*
  • Lateral Ligament, Ankle / surgery*
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Range of Motion, Articular / physiology*
  • Retrospective Studies
  • Time Factors
  • Weight-Bearing
  • Young Adult