Foot & Ankle International - 2017 FAI Supplement - 17S

infection, or deep vein thrombosis (DVT). Secondary outcomes included reoperation rates for implant removal or
irrigation and debridement. Complications were identified
by International Classification of Disease-9 (ICD-9) codes
and reoperations were identified by CPT codes. Chi-squared
tests were used to determine differences in complication
rates between surgeon types. The Charlson comorbidity
index (CCI) was used to compare populations based on
medical risk factors for complications.
Results: 14,222 patients with ankle fractures were treated
by orthopaedic surgeons and 845 patients were treated by
podiatrists. Operative treatment by orthopaedists was
associated with lower DVT (p<0.02) and malunion
(p<0.02) rates among all types of ankle fractures. There
were no differences in complications for patients with
single malleolar fractures, although higher rates of implant
removal (p<0.01) were noted in patients treated by orthopaedic surgeons. For bimalleolar or trimalleolar fractures,
treatment by an orthopaedic surgeon was associated with

Foot & Ankle International, 38(S1)
DOI: 10.1177/1071100717S00014
©The Author(s) 2017

Is Revision Anatomic Ankle Ligament
Repair Augmented With Suture-Tape a
Valuable Alternative for Patients With
Failed Broström Procedure?
Seung-Myung Choi, MD, Byung-Ki Cho, MD, PhD,
Gi-Soo Lee, MD
Category: Ankle, Sports
Keywords: Ankle, Recurrent instability, Failed modified
Broström procedure, Revision ligament repair, Suture-tape
augmentation
AOFAS Annual Meeting 2017

lower DVT (p<0.03) and malunion (p<0.04) rates. No differences were observed in rates of infection or need for
irrigation and debridement based on surgeon type (Table
1). Patients treated by orthopaedic surgeons versus podiatrists were also noted to have a similar median CCI at 2.0
and 2.5, respectively.
Conclusion: Operative treatment of ankle fractures by
orthopaedic surgeons is associated with lower rates of certain postoperative complications compared with podiatrists. Malunion, in particular, is a surgeon related variable
that has a significant impact on functional outcome in
unstable ankle fracture patients. The specific reasons for
the difference in malunion rates is likely multifactorial, and
unable to be answered using this dataset, but warrants further investigation. Our findings have important implications for patients who must choose a surgeon to manage
their operative ankle fracture, as well as policy makers who
determine scope of practice in orthopaedic surgeons and
podiatrists alike.

Introduction/Purpose: Recurrent instability after previous
anatomic ankle ligament repair has been known to be a poor
prognostic factor for revision modified Broström procedure,
and ligament reconstruction procedures using an allograft or
autograft tendon have commonly been recommended. This
prospective study was performed to evaluate the intermediate-term outcomes after revision anatomic ankle ligament
repair augmented with suture-tape for failed modified
Broström procedures.
Methods: Thirty patients with failed modified Broström procedures consecutively underwent revision procedures for
recurrent ankle instability. Of these patients, 27 patients who
could be followed for more than 2 years were analysed in the
current study. The clinical evaluation consisted of the Foot
and Ankle Outcome Score(FAOS), Foot and Ankle Ability
Measure(FAAM) score. Talar tilt angle and anterior talar
translation were measured to evaluate radiologically the
changes of mechanical ankle stability.
17S

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