The results suggest that the value of ATFL length (ATFL stress) and ATFL ratio of stress ultrasound could be used for diagnosis of chronic ankle instability in addition to manual anterior drawer test and stress radiography.
Background
This study assessed the average time to return to training and official game participation after modified Broström operation (MBO) in elite athletes.
Methods
Sixty athletes diagnosed with lateral ankle instability underwent MBO from October 2011 to December 2013. Their average age was 19.3 years, and the average follow-up time was 28.8 months. We measured the time sequence of three phases of rehabilitation: start of personal training, start of team training, and start of the first official game after recovery. Patients were divided into an early return to play (RTP) group and late RTP group. The groups were compared to identify possible risk factors affecting the RTP time.
Results
The mean length of time to return to personal training was 1.9 months, return to team training was 2.9 months, and return to competitive play was 3.9 months. There were no significant differences of any variables including age, sex, body mass index, level of sports, grade of instability, presence of os subfibulare, and preoperative functional score between the early RTP and late RTP groups.
Conclusions
The RTP was 83.3% at 4 months after lateral ankle ligament repair and 100% at 8 months postoperatively. The results provide reference data for orthopedic surgeons in evaluating surgical results and informing patients about expectations after surgery in terms of performance level and timing of return to sports.
Background: The treatment of fifth metatarsal stress fractures can be challenging. Various operative fixation methods have been reported for fracture management. Among them, intramedullary screw fixation has become increasingly popular. However, recent reports have described failures after screw fixation in athletes. The aim of this study was to determine the rates of clinical and radiographic healing, time to return to sport, and complications of elite athletes with proximal fifth metatarsal fractures treated with plantar plating. Methods: Thirty-eight athletes with fifth metatarsal stress fractures treated using a plantar plating technique in 3 hospitals from 2013 to 2018 were evaluated retrospectively. Demographic data, radiographic evaluation, and the time until union and return to sports activities were collected and analyzed. A total of 38 patients underwent the plantar plating for a fifth metatarsal stress fracture with a mean follow-up of 23 (range, 12-49) months. Results: The mean time to the radiologic union, as determined by plain radiography, was 9.3 (range, 8-16) weeks. Although there were no nonunions or delayed unions during follow-up, 4 refractures developed (10.5%). All but 1 patient were able to return to their previous levels of sporting activity at 22.2 ± 4.5 (range, 12-40) weeks. Conclusion: With a minimum of 1-year follow-up, the described plantar plating technique could be an alternative method for the operative treatment of fifth metatarsal stress fractures without nonunion problems. Level of Evidence: Level IV, case series.
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