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Is it necessary to remove small fibular ossicles during an arthroscopic modified Broström operation for chronic lateral ankle instability?

Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Ankle sprains are the most frequent musculoskeletal injury in sports. Patients reporting pain at the lateral malleolus tip following ankle sprains or sports activities frequently have separated ossicles, referred to as an os subfibulare (OSF). Commonly, small ossicles accompanied by chronic lateral ankle instability (CLAI) are treated with ossicle resection combined with the modified Broström operation (MBO). We compared the clinical and radiological results between groups in which a small OSF was or was not removed. METHODS: We retrospectively enrolled all patients with a small OSF who underwent arthroscopic MBO by one surgeon in one institution between 2015 and 2022. The study included skeletally mature patients who had an OSF among those who had MBO surgery and follow-up for at least 1 year. An ossicle was defined as small if the longitudinal diameter was < 5 mm on an anteroposterior plain radiograph. RESULTS: There were no significant differences between the groups preoperatively or 6 or 12 months postoperatively. The radiographic findings did not differ significantly between groups. CONCLUSIONS: When performing arthroscopic MBO on patients with CLAI, OSF ≤ 5 mm removal did not alter clinical or radiological outcomes, suggesting that excision may not be needed in asymptomatic patients. Considering the risks of the removal process, leaving it alone may be a treatment option. CLINICAL TRIAL NUMBER: Not applicable.
DOI: 10.1186/s12891-025-08546-7
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W4409685926
FWCI: 1.837
Cites: 31
Cited by: 2
Related to: 10