• Journal of Korean Foot and Ankle Society
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• v.20 no.2
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• pp.62-66
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• 2016

A modified $Brostr{\ddot{o}}m$ procedure has been widely accepted as a treatment of choice for patients with chronic lateral ankle instability. The procedure is highly reliable and provides successful outcomes in approximately 90% of cases. Severe degree of instability, absence or poor quality of the ligamentous remnant, obesity, and generalized joint hypermobility have been regarded as poor prognostic factors related to the modified $Brostr{\ddot{o}}m$ procedure. However, these perceptions are based on a low level of evidence studies or expert opinions. Therefore, the aim of this article was to search for evidences regarding the poor prognostic factors of the modified $Brostr{\ddot{o}}m$ procedure.

• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.6-11
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• 2019

As a result of the increased participation in recreational and competitive sports activity, the incidence of chronic lateral instability has risen. Because chronic ankle instability can cause significant comorbidity and increase the social cost, the interest in this issue is growing. Although there are well-documented and effective surgical treatments for managing this condition, conservative treatments are a viable first option in selected patients. Through conservative treatment, surgical treatments can be reduced or delayed without necessarily affecting the overall outcome, but the failure of conservative treatment results in the need for surgical treatment to reduce the long term complications. Appropriate postoperative rehabilitation is essential for adequate functional recovery, even when surgical treatment is required.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.175-178
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• 2009

Purpose: To evaluate the result of modified Br$\ddot{o}$strom procedure with anchor suture and explore associate lesion under arthroscopy for chronic lateral instability. Materials and Methods: From May 2005 to March 2009, Retrospective analysis of 126 patients with chronic lateral instability who underwent modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure was done. Mean follow-up period was 13 months. Results: Chronic lateral instability of the ankle almost had local synovitis by arthroscopic examination. There were osteochondral lesion of talus on the anteromedial aspect in 63 cases, on the anterolateral aspect in 25 cases, osteochondral lesion of tibia side in 8 cases, fat hypertrophy of tibiofibular space in 120 cases, anterior fat impingement in 26 cases, intra-articular loose body in 13 cases. Mean Karlsson scoring scale was improve from 53 preoperatively to 91 postoperatively, There were 70 cases excellent, 27 cases good, 26 cases fair, 3 cases poor result according to the Sefton procedure. Conclusion: Modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure are reliable treatment method for chronic ankle lateral instability which has intraarticular pathology.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.83-92
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• 2023

PURPOSE: This study examined the effect of using a smartphone according to the direction of wearing a bag on muscle characteristics and balance ability in adults in their 20s with chronic ankle instability. METHODS: Twelve people with chronic ankle instability were examined for three weeks. The types of carrying a bag were classified into three conditions: to the right, to the left, and on both sides. The muscle characteristics and balance ability were measured and analyzed. The one-way ANOVA was used to obtain a difference between conditions. RESULTS: A significant difference in the muscle tone of medial gastrocnemius was observed between the dominant group and the non-dominant group. The muscle tone and stiffness of the peroneus longus decreased significantly after walking with a smartphone and carrying a bag. The maximum slope of the forward and reverse directions increased and decreased significantly, respectively, after walking with a smartphone and carrying a bag on both sides. CONCLUSION: In this study, muscle fatigue causes a decrease in muscle tone and stiffness with chronic ankle instability when carrying a heavy back while walking, and there were asymmetric changes in the balance ability. Therefore, adults with chronic ankle instability should carefully avoid carrying a heavy bag for extended times, irrespective of the style or type of the bag.

• Journal of the Korea Society of Computer and Information
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• v.27 no.1
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• pp.97-105
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• 2022

The purpose of this study was to analyze the effects of flossing band exercise on the range of motion and vertical jump for taekwondo demonstration athletes with ankle functional instability. The subjects of this study were 21 male Taekwondo Demonstration Team athletes enrolled at D University. They were divided into functional ankle instability group(FAIG, n=7), mild ankle instability group(MAIG, n=7), and ankle stability group(ASG, n=7). All groups performed a acute flossing band exercise program. The results of this study are as follows; dorsi flexion(p<.01), inversion(p<.01), eversion(p<.05) and vertical jump(p<.01) were significantly increased in the FAIG. Flossing band exercise of Taekwondo demonstration team with FAI increased joint range of motion and vertical jump. Therefore, it was confirmed that it could be an intervention that can improve performance and reduce the risk of ankle injury.

• 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 Foot and Ankle Society
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• v.25 no.3
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• pp.117-125
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• 2021

Purpose: The aim of this study was to evaluate biological ligament healing quantitatively after suture-tape augmentation for chronic lateral ankle instability. Materials and Methods: Thirty-two patients underwent magnetic resonance imaging (MRI) at a minimum of 2 years after lateral ligament augmentation using suture-tape. Signal/noise ratios (SNRs) and widths of anterior talofibular ligaments (ATFLs) were measured on preoperative and postoperative MRI by three researchers. ATFL biological healing degrees were analyzed using changes in SNRs and widths of ATFLs and by comparing these metrics with those of normal contralateral ankles. Clinical evaluations were performed using foot and ankle outcome scores (FAOSs), Foot and Ankle Ability Measure (FAAM) scores, and ankle stress radiographs. Results: Mean FAOS and FAAM scores improved significantly from 62.4 to 93.6 and 58.3 to 92.3, respectively, at final follow-up (p<0.001). Mean SNRs and ATFL widths improved insignificantly from 8.49 to 8.21 and 2.07 to 2.15 mm, respectively, at final follow-up (p=0.424, p=0.718). Significant differences in mean SNRs and ATFL widths were found between ipsilateral and contralateral sides (p<0.001, p=0.002). Spearman's correlation analysis revealed no significant association between clinical outcomes and degrees of biological healing of ATFLs based on MRI findings. Conclusion: Despite improvements in clinical outcome measures, the effects of suture-tape augmentation for chronic lateral ankle instability on biological ligament healing were insignificant. In addition, no significant correlation was found between clinical outcomes and degrees of biological healing of ATFLs.

• Korean Journal of Applied Biomechanics
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• v.34 no.2
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• pp.93-103
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• 2024

Objective: The purpose of this study was to investigate whether dancers with chronic ankle instability (CAI) exhibit different characteristics in dynamic postural control ability and ankle joint laxity compared to dancers without CAI and non-dancers with CAI. Method: Twelve dancers with CAI, 14 dancers without CAI, and 12 non-dancers with CAI participated in the study. Dynamic balance was evaluated using the Star Excursion Balance Test (SEBT) and the single-leg hop balance. The laxity of the ankle joint was evaluated through the anterior drawer test and the talar tilt test. SEBT measured maximum reach distances in anterior, posteromedial, and posterolateral directions. Single-leg hop assessed center of pressure (COP) and time-to-boundary (TTB) outcomes. One-way ANOVA and Chi-square tests were performed to compare the outcome variables among the three groups. Results: Dancers with CAI demonstrated greater reach distance in the posterolateral direction compared to non-dancers with CAI during SEBT (p=.014). Secondly, dancers without CAI showed greater reach distance in the posterolateral (p<.001) and posteromedial (p=.001) directions during SEBT compared to non-dancers with CAI. Additionally, dancers without CAI exhibited better postural control with higher TTB AP mean of minima (p=.003) and TTB AP standard deviation of minima (p=.012) during single-leg hop compared to nondancers with CAI. Thirdly, dancers with CAI showed a lower positive rate during the anterior drawer test compared to non-dancers with CAI (p=.019). Conclusion: Dancers with CAI demonstrated better ankle function and reduced mechanical instability compared to non-dancers with CAI. Therefore, to elucidate the underlying mechanisms of lateral ankle sprain and CAI development exacerbation in dancers, additional factors that can affect ankle sprain, such as visual dependence during postural control and evaluation in dance movements, should be explored.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.66-72
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• 2002

Purpose: To evaluate the overall results and its major affecting factors(athlete/associated injury) of modified Brostrom procedure for chronic ankle lateral instability. Materials and Methods: Fifty-one patients (51 ankles) with chronic ankle lateral instability were sub-grouped athletes and non-athletes and again sub-grouped with associated injury and without associated injury. Associated injuries were osteochondral defect(6), peroneal tendon abnormality(10), os subfibularae(4), os subtibialae(4), anterior impingement(5) and loose body(2). The overall surgical results were evaluated and also see whether or not athletes and associated injury affect the result. Result: Of the 51 operations performed, there were 39 excellent, 8 good and 4 fair as a whole. Of the 24 athletes operated, there were 19 excellent, 3 good, and 2 fair. Among the 27 non-athletes, there were 20 excellent, 5 good and 2 fair results. The average time to ordinary life in the non-athlete group was 2.5 months and average time to sports activity in the athlete was 4.5 months postoperatively. Those who didn't have any associated injury had all excellent result, on the contrary, those who had associated injuries, 14 excellent, 8 good and 4 fair results. All the fair results were associated with osteochondral lesion of talus. Whether or not the patient is athlete does not affect the surgical results, but whether or not there were associated injuries does affect the surgical results. Conclusion: Modified Brostrom procedure for chronic ankle lateral instability itself is an excellent to good operation. This procedure can be used in athletic populations who need high demand of sports activity. But chronic ankle lateral instability with associated injury group showed variable, less satisfactory results than those without associated injury. Careful preoperative and intraoperative examination should be done to find out the associated injury with chronic ankle lateral instability.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.261-264
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• 2002

Purpose: To investigate the clinical features of fistulas of the ankle joints. Materials and Methods: Seven fistulas in seven patients were reviewed during Apr. 2000 to Mar. 2002, retrospectively. There are five men and two wemen. Average age was 47.7 years (range, 42-65 years). Average follow-up period was 1.4 years. There were six cystic lesions after ankle sprain and one patient with persistent discharge after excision of bursa over lateral malleolus. Results: Duration from injury to presentation was average 9.8 years. The site of preoperative swelling was mostly over the lateral malleolus in five patients. In one patient, the area of swelling was extended to the anterolateral ankle joint and in another patient there was extensive swelling from Achilles tendon to the anterolateral ankle joint. Concomitant symptoms were instability in three patients, pain and instability in three patients. Methods of surgery were simple repair in one, modified Brostrom in three, augmentation with periosteal flap in addition to modified Brostrom in two and Chrisman-Snook in addition to augmentation with periosteal flap and modified Brostrom in one. There were no recurrence of instability as well as fistula. Conclusion: We think that the fistula of the ankle joint should be included in the differential diagnosis of the cystic lesion over the lateral malleolus and the result of surgical treatment would be satisfactory in most cases.