Performed by – David Hinsley, Ngwe Phyo, Nick Ward

The ankle joint attaches the foot to the leg. There are strong ligaments that attach from the shin bone (tibia) and fibula to the talus and calcaneum (heel bone). The lateral ligaments are frequently injured during sporting activity, when the ligaments are partially torn it is termed an ankle sprain. Ankle sprains are the most common musculoskeletal injury that presents to Accident and Emergency departments.

Ankle instability is most common in patients that have had previous ankle sprains. The ankle can give way when walking and may occur with the slightest unevenness of the ground. It can be painless, often if the ligaments are completely ruptured or painful if they are stretched. If the ankle is unstable there is a risk that arthritis can ensue.

Physiotherapy and ankle braces may be useful in controlling ankle stability and wearing boots rather than shoes is often more comfortable and provides additional support. Despite this conservative treatment surgical stabilization of the ankle may be required.

Ankle stabilisation procedures:

Modified Brostrom-Gould procedure
This operation involves making a cut over the ligaments on the outer aspect of the ankle. The slack ligaments are cut and then repaired by “double-breasting” the ligaments which tightens them to the correct tension. The wound is closed using dissolvable sutures.

Following the operation, you will be placed into a half-cast with your foot held at right angles to the leg. You will be reviewed at two weeks to ensure that the wounds have healed and to convert the half cast to a completed cast. Partial weight-bearing can be commenced at this stage.

At six weeks following the operation the cast is removed and an ankle brace is worn in its place. Physiotherapy is commenced at this stage and at three months following surgery the ankle brace may be removed.