Safety and Efficacy of One vs Two Incision Broström Gould with Calcaneal Osteotomy and Peroneal Tendon Debridement Surgery

Category: Hindfoot; Ankle Introduction/Purpose: Ankle sprains are a common musculoskeletal injury, and a substantial proportion of patients develop chronic ankle instability (CAI). Surgical intervention, such as the Broström-Gould (BG) procedure, is typically indicated for treatment. We are comparing the safety and efficacy between the BG with peroneal tendon debridement repair, a sliding lateralizing calcaneal osteotomy and additional adjuvant procedures performed with a single- versus double-incision approach. In this study, we aim to identify if a less invasive, single-incision procedure may result in decreased risk of wound complication and improved patient reported outcomes. Methods: Our retrospective analysis included patients who underwent the procedure of interest between 2011 and 2020. Patients were divided into two groups: undergoing either a one-incision (n=53) or a two-incision approach (n=47), both with a lateralizing calcaneal osteotomy. Demographics, complications, and PROMIS scores were collected. Statistical analysis was performed. Results: Initially, 264 patients were identified, and following application of our inclusion and exclusion criteria, 100 patients remained for the study. Most notably, a significant difference in skin bridge breakdown was observed between the two-incision (n = 6 (13%)) and one-incision groups (n = 0 (0%)). There were no significant differences in infection, deep wound dehiscence, nerve palsy, or neuroma between patients in the two groups. Furthermore, no statistically significant differences in mean PROMIS scores existed between the cohorts. Conclusion: The described modified technique BG procedure shows promise for treating CAI. While patients in both single- and double-incision groups had similar rates of postoperative complications, the decreased incidence of skin bridge breakdown in the one-incision group highlights the approach’s safety and potential benefits in reducing wound-related complications. Our research contributes valuable insights into foot and ankle surgery, offering an innovative option for patients with chronic ankle instability and potentially enhancing patient care in the management of this condition.