Ankle ligament reconstruction is an operation to repair or reconstruct the lateral ankle ligaments that have been damaged by recurrent ankle sprains, restoring ankle stability.
An incision is made over the outer ankle. In a Broström repair, the stretched or torn anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) are shortened and reattached to the fibula using suture anchors. The inferior extensor retinaculum may be used to reinforce the repair (Broström-Gould modification). The operation takes approximately one hour.
Surgery is recommended for chronic ankle instability with recurrent sprains and giving way that has not responded to physiotherapy and bracing. Most patients have had multiple ankle sprains over months to years.
Physiotherapy focusing on proprioception and peroneal strengthening, ankle bracing, activity modification. These are effective for most patients with ankle instability.
MRI to assess ligament and cartilage damage. Stress X-rays may be performed. Standard pre-assessment.
Restoration of ankle stability in approximately 85-95% of patients. Most patients return to sport.
Temporary loss of full dorsiflexion.
Expected for several weeks.
The repair may stretch over time. Risk approximately 5-10%.
Numbness on the outer side of the foot.
Numbness on top of the foot.
Wound infection.
General or spinal anaesthesia with ankle block.
Cast or boot for two to six weeks. Weight-bearing as tolerated after two weeks. Physiotherapy for proprioception and strength. Return to running at three months. Return to sport at four to six months.
Reviews at two weeks, six weeks, and three months.
The Broström repair has excellent long-term results with approximately 85-95% stability. However, no surgery can make the ankle immune to future injury.