Modified Broström repair versus internal ankle bracing augmentation with modified Broström procedure in chronic lateral ankle instability: a systematic review and meta-analysis

Abstract

Background Lateral ankle instability is a major orthopaedic challenge with Lateral ankle sprains accounting for almost 85% of all ankle sprains. Ankle sprains in the majority of patients settle with conservative treatment. However, 20–40% of patients usually develop recurrent sprains and chronic ankle instability (CAI). Limited results of the Broström procedure opened the gate for multiple modifications such as augmentation using a part of the extensor retinaculum (Broström-Gould technique) with the use of suture anchors or to re-enforce reconstruction with suture tape. Objective To conduct a systematic review and meta-analysis comparing the modified Broström repair (MBR) with the modified Broström procedure and internal ankle bracing augmentation as regards clinical outcomes, re-tear, and other complications. Patients and methods This study was conducted following the preferred items for systematic reviews meta-analysis (PRISMA) 6 guided items and a checklist to answer the question of which is better as regards improving clinical outcomes and complications between 1/1/2010 and 1/6/2022. Results This review included 5 studies, 3 of which were randomized control trials (RCT), 384 patients were included, 170 patients underwent the Internal ankle bracing augmentation with the modified Broström procedure, and 214 patients underwent the modified Broström procedure. The results of the comprehensive review demonstrated that modified Broström repair using the internal brace augmentation was superior to solitary modified Broström repair and facilitated early recovery and restoration to the preinjury activity level in the majority of patients with no statistically significant difference. Moreover, there was no significant difference between the two groups regarding the Foot and Ankle Outcome Score (FAOS), the Foot and Ankle Ability Measure (FAAM), Revision Surgery Rates, and Overall Complications. Conclusion Despite the anticipated mechanical stability for internal ankle bracing over modified Broström repair the current meta-analysis did not show statistically significant superiority of the internal ankle bracing over the modified Broström repair.