Lateral ligament reconstruction of the ankle for chronic symptomatic mechanical instability is a relatively common procedure for Foot and Ankle surgeons to undertake. The following method has been undertaken by the Senior Author for the past ten years.
We studied 26 patients (26 feet). The average age was 32 years with 16 males and 10 females. Duration of follow up was from 11 months to 11 years.
Functional instability and alternative diagnoses such as tendonopathy and previously unrecognised fractures were excluded, sometimes by extensive investigations. All patients undergoing surgery had a period of conservative treatment which had failed. Stress radiographs confirmed instability in two planes and was either undertaken preoperatively or just prior to surgery under anaesthesia.
Through a small oblique lateral incision, the lateral capsule, ligaments and periosteum were advanced over the tip of the fibula in a proximal and posterior direction and re-anchored tightly to the bone, usually with Mitek (titanium) bone anchors.
The patients were casted for six weeks whilst weight bearing, followed by six weeks of physiotherapy.
The success rate was over 85%. The complications were scar tenderness, recurrent instability and ankle spurring. There were no complications caused by the metallic anchors.
This procedure has a comparable success rate with similar anatomical ligament reconstructive procedures and can be recommended.
