Ankle Ligament Stabilisation

Ankle stabilisation is a procedure carried out to strengthen and support a hypermobile or unstable ankle joint. Ankle instability is generally caused due to an ankle sprain or injury which may result in stretching or improper healing of the ligaments that support the ankle joint. If the ankle is not adequately supported there is a risk of dislocation or fracture when weight bearing or moving quickly. To avoid such complications, ankle stabilisation must be performed as soon as possible.

Your doctor may check for hypermobility of the joint which could be a sign of ankle instability. The initial conservative approach to stabilise your ankle could include wearing a special cast or participating in physical therapy to strengthen the muscles in your foot and ankle. Ankle stabilisation required for a particular sport or activity can be provided by taping the joint or using a brace. If these options fail, surgical treatment for ankle stabilisation may be required. The surgery may usually be formed under local anaesthesia and you can go home on the same day. The 2 main types of surgical intervention are:

• Anatomic Reconstruction: The stretched or torn ligament is allowed to heal in a shortened position to provide better stability to the joint. The tendon may be repaired using the patient’s own tissue (Broström procedure) or an allograft (cadaver tendon). Tightening of the fibrous tissue (retinaculum) that holds the ankle in correct alignment may also be done. This procedure requires a relatively small incision, better healing, and provides full mobility of the joint.
• Peroneal Substitution Ligament Reconstruction: Replacement of the injured ankle tendon with a piece of another tendon from the ankle, the peroneal tendon. This procedure also requires a larger incision and a greater recovery time.

Following the surgery, you will be placed in plaster splint and will have to avoid bearing weight on the affected foot for two weeks. The plaster splint will then be replaced with a removable boot for another 4 weeks. Physical therapy is initiated at 6 weeks with ankle support to be worn for at least 3 months after surgery after which you may return to activities of daily living. As with any surgical procedure the risks of surgery include bleeding, infection, damage to surrounding structures, and failure to heal.