Biomechanical Analysis of Brostrom Versus Brostrom-Gould Lateral Ankle Instability Repairs
Biomechanical Analysis of Brostrom Versus Brostrom-Gould Lateral Ankle Instability Repairs
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DOI：
10.1177/1071100713477622
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发表时间：
2013-04-01
影响因子：
2.7
通讯作者：
DiGiovanni, Christopher W.
中科院分区：
文献类型：
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作者：
Behrens, Steve B.;Drakos, Mark;DiGiovanni, Christopher W.
背景资料：传统Brostrom修复术和改良Brostrom-Gould修复术是2种历史上用于解决踝关节外侧不稳定的可靠手术。本研究的目的是在一个不稳定的尸体踝关节模型中，比较Brostrom修复术和Brostrom-Gould改良术的生物力学稳定性。方法：将10具尸体标本置于Telos踝关节应力仪中，先取前后位，然后取侧卧位，同时施加170 N载荷以分别模拟前抽屉（AD）和距骨倾斜（TT）试验。在这两种情况下，踝关节保持在15度跖屈、中立和15度背屈，同时使用视频运动分析系统测量传感器的运动。计算AD试验中距骨和胫骨之间的平移测量值以及TT试验中胫骨和距骨之间的角度，用于（1）完整，（2）切片（ATFL和CFL的划分），（3）Brostrom修复和（4）Gould修改状态。当与修复状态和完整状态相比时，在TT和AD测试期间，切片状态在所有踝关节位置均表现出增加的内翻和平移。此外，在完整状态和修复状态之间没有发现显著差异。最后，没有差异的生物力学稳定性可以确定之间的传统Brostrom修复和修改Brostrom-Gould procedure.Conclusions：我们的研究结果表明，有没有显着的生物力学差异，在初始踝关节稳定性增强传统Brostrom修复与古尔德修改在这个时间零尸体模型。
Background: The traditional Brostrom repair and the modified Brostrom-Gould repair are 2 historically reliable procedures used to address lateral ankle instability. The purpose of this study was to evaluate the biomechanical stability conferred by the Brostrom repair as compared to the Brostrom-Gould modification in an unstable cadaveric ankle model.Methods: A total of 10 cadaveric specimens were placed in a Telos ankle stress apparatus in an anterior-posterior position and then in a lateral position, while a 170 N load was applied to simulate anterior drawer (AD) and talar tilt (TT) tests, respectively. In both circumstances, the ankle was held in 15 degrees of plantarflexion, neutral, and 15 degrees of dorsiflexion, while the movement of the sensors was measured using a video motion analysis system. Measurement of the translation between the talus and tibia in the AD test and the angle between the tibia and talus in the TT test were calculated for specimens in the (1) intact, (2) sectioned (division of the ATFL and CFL), (3) Brostrom repair and (4) Gould modification states.Results: When compared to both the repaired states and the intact states, the sectioned state demonstrated increased inversion and translation at all ankle positions during TT and AD testing. Furthermore, no significant differences were found between the intact state and either of the repaired states. Finally, no difference in the biomechanical stability could be identified between the traditional Brostrom repair and the modified Brostrom-Gould procedure.Conclusions: Our findings indicate that there is no significant biomechanical difference in initial ankle stability conferred by augmenting the traditional Brostrom repair with the Gould modification in this time-zero cadaveric model.