The Broström Procedure: Restoring Stability To Loose Ankles

Written by admin on April 12, 2013 – 10:42 am -

The arrival of spring’s warmer weather brings with it the desire to get more active. We are spending more time on the tennis courts, the golf course, the ball field, etc., providing opportunities to burn some energy and have fun … but unfortunately, being active also carries with it a risk of accidents and injury.

The ankle sprain is one of the most common injuries sustained by athletes and non-athletes alike. Simply stated, the “sprain” is a stretching or tearing of the lateral (outside) ligaments of the ankle: anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). One or all of these ligaments may be damaged in a sprained ankle, and though uncommon, other ankle ligaments may also be damaged. The classic mechanism of such an injury is “rolling,” or inverting, the ankle after landing on another player’s foot or stepping on an uneven playing surface. This inversion mechanism of injury causes the ligaments to stretch, partially tear, or completely rupture. Very severe injury or repeated injury may ultimately result in chronic ankle instability. This results in decreased function of the ankle joint and becomes quite a nuisance for competitive athletes.

The primary treatment in both acute and chronic cases begins with external stabilization using ankle braces. This is combined with a rigorous rehabilitation program guided by a physical therapist. When conservative treatment measures fail and instability of the ankle becomes a daily issue, surgical intervention may be considered. The Broström procedure is primarily used to repair the ATFL; however, the CFL (and even more rarely, the PTFL) may be repaired during the procedure as well. By repairing these damaged ligaments, proper ankle mechanics and function are restored. The ultimate goal is to restore the ankle to its pre-injury state. The procedure has a 90% success rate, and athletes usually return to play within three-four months.

Recovery time after the surgery may vary depending on each patient’s response. Typically, there is a six-week period of time when the ligaments are allowed to heal. During these six weeks, the patient will be non-weight bearing or limited weight bearing status (in a boot) and only allowed to do light range of motion activities. After the initial six-week healing time, physical therapy is introduced to help regain proper ankle strength, range of motion, proprioception, and restoring a normal gait (walking without a limp). Returning to high level activities may take up to six months; however, it may be sooner depending on each individual.

Unfortunately, ankle injuries are a common result of today’s active lifestyles. If you happen to fall victim to an ankle injury and traditional treatments just don’t seem to help, remember that there are other alternatives available, and the Broström procedure may be the answer for you.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at 919-562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com, or on Twitter @drmarkgalland.

Matt Rongstad, ATC/LAT is a post-graduate fellow of the GOSM program at OSNC.

The above article was published in Circa Magazine (April-May-June 2013).


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