Collateral Ankle Ligament Repair

Abstract

Patients with chronic lateral ankle instability may become surgical candidates when they have not responded favorably to non-operative care. Lateral ankle stabilization procedures are often grouped into two general groups, anatomic and nonanatomic repairs. Anatomic repair of the anterior talofibular ligament was first described by Broström in 1966. Gould later modified this technique in 1980. Traditionally, lateral ankle stabilization is performed via an open approach. The open techniques remain acceptable, predictable, and efficient with the advantage of direct visualization of all targeted structures and simultaneous management of any peroneal tendon pathology. In recent years however, numerous authors have described and advocated for arthroscopic and arthroscopically assisted techniques for lateral ankle stabilization. These techniques have the advantage over traditional open techniques of addressing intra-articular pathology at the same time as the ligamentous instability. Both open and arthroscopic techniques will be detailed within this chapter. Beyond lateral ankle ligament stabilization, surgical repair may be required for deltoid insufficiency and/or ligamentous injury to the syndesmosis secondary to isolated soft tissue injuries, not involving malleolar fracture.