Lateral Ankle Ligament Reconstructive Surgery
Ankle ligament laxity, or a loose ankle joint, is relatively common after suffering multiple ankle sprains. When ankle bracing and physical therapy fail, the final, definitive treatment plan involves surgical intervention. Thankfully, there are several options and the recovery isn’t intolerable.
The Modified Brostrom Procedure
The most basic type of lateral ankle ligament reconstruction is the modified Brostrom procedure. In this procedure, the anterior talofibular ligament, which is often scarred and loosened, is cut in half and sewn over top of itself, to tighten the outside of the ankle. This prevents further sprains and often reduces ankle arthritis (as long as it hasn’t developed yet). The procedure can be modified further to create additional tightening by incorporating another ligament—the inferior extensor retinaculum—to further cinch down the lateral structures.
Often this procedure can leave your ankle stiffer than it was before surgery, but that is partly why it’s performed. Physical therapy after the stitches are removed—around two weeks—can prove beneficial in regaining ankle and subtalar joint range of motion while maintaining surgical correction. We routinely prescribe physical therapy for six weeks after being non-weightbearing for the first three to four weeks after surgery.
Some ankles require further stabilization than the typical Brostrom repair. Several other techniques have been described to use a tendon to stabilize the ankle joint, including the Elmslie, the Watson-Jones, and the Chrisman-Snook procedures. The names are less important here than the actual procedures, which all involve taking either a cadaver allograft tendon or sacrificing your own peroneal tendon to perform a sort of “soft tissue fusion” of the subtalar joint. These procedures are more powerful, but require more downtime as well, and are often only performed after a Brostrom has proven to be insufficient.
Surgical Foot and Ankle Repair at Eagle-Summit
No matter what type of repair is needed for your foot and ankle, from bone to soft tissue and from nails to ankle fractures, our team at Eagle-Summit Foot & Ankle can help get you back on your feet.