Surgical Treatment of Subfibular Ossicle in Children: A Retrospective Study of 36 Patients with Functional Instability
Résumé
Backgrounds: To evaluate the surgical management of a symptomatic subfibular ossicle after severe ankle sprain with functional instability and pain sequelae in children. Methods: We analyzed 36 patients complaining of functional instability without laxity, 1 year after an ankle inversion trauma associated with the observation of a subfibular ossicle. We systematically suggested the open excision of the residual ossicles, followed by 6 weeks of immobilization and proprioceptive physiotherapy. Seventeen of them, constituting the ``resection'' group accepted this surgical approach. The remaining 19 patients, the ``control'' group, received only rehabilitative care. The American Orthopaedic Foot and Ankle Society ankle pain and function score was evaluated in both groups. Results: The mean latest follow-up was 4 years and 4 months (range, 1 y 8 mo to 14 y 7 mo). A significant improvement of the American Orthopaedic Foot and Ankle Society score was observed and was significantly higher in the resection group with a mean gain of 31 points (SD = 31.8), versus 7 points (SD = 7) in the control group (P < 0.001). Conclusions: We conclude that in the absence of objective laxity, excision of the os subfibulare appears as a simple and effective technique in the treatment of posttraumatic functional instability and ankle pain.