Ankle Instability Surgery / Reconstruction
What is ankle stabilisation surgery?
Ankle stabilisation surgery is typically considered for patients with chronic ankle instability, particularly when conservative treatments like physiotherapy, bracing and conservative care have not been effective. Chronic ankle instability often results from repeated ankle sprains or injuries, leading to weakened or torn ligaments. The surgery aims to repair, tighten and strengthen the ankle ligaments. The podiatric surgeon, Dr Abdel Kak will help restore normal ankle joint biomechanics and help prevent damage to the articular joint from re-ocurring sprains.
Lateral ankle surgery (Brostrom – Gould procedure) is performed through a small incision on the tip of the fibular. The damaged ligaments are identified, repaired and tightened back to their anatomical position. This is usually done with bone anchors and a combination of strong sutures.
What is the recovery after ankle stabilisation surgery?
Following lateral ankle stabilisation, patients are placed in a Backslab cast and will be non weight bearing for 2-4 weeks. Following this the patient will be transitioned into a CAM boot walker for 4 weeks and then later move into an ankle brace and footwear. Physical therapy is incorporated to help strengthen your ankle and restore motion.
The ankle is generally numb with local anaesthetic for 12 – 24 hours and simple
painkillers such as paracetamol and anti-inflammatory medication are taken for the first week or two. Strong painkillers if required are only generally needed in the first week after surgery. Dressings and bandages must stay intact and dry until your 1 and 2 week review where your wounds are checked for healing, and your foot and ankle is checked for mobility.
What are some of the risk and complications of ankle stabilisation surgery?
During the preoperative consultations, Dr Abdel Kak will answer all your questions and discuss the potential risk and complications associated with ankle stabilisation surgery. Although they are usually rare, some of risks and complications include;
- Wound infection – with any surgical procedure, there is a small risk of getting an infection. This occurs in less then 1% of patients and the surgeon will give you antibiotics to treat or help prevent an infection from occurring
- Recurrence of deformity – the ankle can give away again needing further surgery. If the appropriate post-operative rehabilitation is performed this is a rare occurrence.
- Scar formation – in most cases you are left with a faint line which gradually reduces with time. In some instances and skin types the scar can become thickened
- Injury to surrounding superficial nerves
- General risks and complications from any foot surgery which can include; continuous pain, deep vein thrombosis and a possibility of reacting to the anaesthesia (general and local)
Frequently Asked Questions
Lateral ankle stabilisation surgery is usually performed as a day procedure and you are able to go home the same day.
Following the completion of your procedure, you are transferred to a recovery area and your vital signs monitored. You may experience some nausea, pain and be slightly disoriented while the general anaesthesia wears off. The medical staff will ensure you are comfortable, assist you to recommence eating and contact your support person to arrange your pickup. Prior to being discharged, the podiatric surgeon will talk to you briefly going over the procedure, post-operative medications and the post-operative instructions.
During the procedure, a local anaesthetic injection is given makes the foot numb for 12 – 24 hours. Simple painkillers such as paracetamol and an anti-inflammatory medication are taken for the first week or two. Strong painkillers are prescribed and if required are only generally needed in the first week after surgery.
After lateral ankle repair/staibilsation you will typically be non weight bearing. You will be using crutches or a mobility aid (knee scooter) to help you get around. It is important you rest to manage the pain and allow the soft tissue to heal in the desired positions. Dressings and bandages must stay intact and dry until your 2 week review where your wounds are checked for healing, and your ankle is checked for stability.
Non – typically you will be placed in a backslab/cast for the first 4 weeks and not allowed to weight bear. You then would be fitted into a CAM walker where weight bearing will commence.
Healing, recovery times and work circumstances vary for each individual. Generally, if your job involves predominantly you sitting, you can expect to return to work in 4 weeks. However if your job requires you to be more active, walking or long periods of standing then you can expect to be back at work in 12 weeks.
Following ankle stabilisation surgery, the typical post-operative appointments are:
- 1 week
- The cast and bandage are changed and the wound and foot is reviewed
- 2 weeks
- The cast and bandage are removed, the sutures removed and a smaller compression bandage is applied.
- 2-4 weeks
- The cast is removed, a light dressing is applied on the wound, you are able to get the foot wet and now will be fitted into a CAM walker to wear.
- 8 weeks
- The CAM boot is removed and you are fitted into an ankle brace and supportive footwear. The ankle is assessed for stability and physical therapy/rehabiliiton is performed to strengthen the ankle.
- 12 weeks
- You will still be expected to wear the ankle brace for 3-6 months after the procedure. The ankle may feel stiff with some residual swelling but you should be able to gradually return to physical activities.
Disclaimer: The information provided here is for general educational purposes only. Individual circumstance can differ, please contact Dr Abdel Kak’s rooms to discuss if surgery is appropriate for you.