Repairing Ankle Instability

In the U.S., there are approximately 30,000 ankle sprains per day, totaling up to 2 million per year. Up to 20% of outer ankle sprains can lead to chronic pain and instability. When rehabilitation methods such as bracing, physical therapy and medication do not control chronic ankle instability, another option for repair is lateral ankle stabilization. 

The ankle is a hinge joint that allows motion up-and-down as well as side-to-side. The foot and ankle are tightly connected by several ligaments, strong band-like structures that help stabilize the ankle. 

“Lateral (outer) ankle sprains are very common, especially in sports like volleyball and basketball. They may occur with any twisting or pivoting motion and can happen to anyone,” said Podiatrist Dr. Tyler Harrell of Avera Medical Group. “Chronic ankle instability is characterized by recurring giving way of the outer side of the ankle, usually the result of repeated ankle sprains or the ankle giving way during routine daily activities. The giving way often occurs while walking or doing other activities when the foot lands in an unusual position, but it can also happen with the simplest of activities and movement.”

The repeated sprains can stretch and tear the ligaments connecting the ankle and foot, making the connection loose and unstable. Symptoms of chronic ankle instability include: 

• A repeated turning of the ankle, especially on uneven surfaces or when participating in sports
• Persistent discomfort to the outer ankle
• Wobbly or unstable feeling in the ankle as well as difficulty with uneven terrain

Surgical repair is done through an outpatient procedure called lateral ankle stabilization. During the procedure, a surgeon will first reinforce the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL), as needed, from where they attach to the fibula, also known as the outside calf bone. The surgeon will then repair the ligaments and attach them to the fibula and to the talus and calcaneus ankle bones as necessary, using small anchors that are drilled into the bone. 

“After surgery, patients must limit bearing weight on the ankle for a period of time, which hopefully with healing is only four to six weeks. This is followed by a gradual return to activity with physical therapy if needed,” said Dr. Harrell.

Once the surgical repair has fully healed, patients have stronger, stable ankles that should no longer give out with a full range of motion. Patients should also experience less pain and experience fewer to no ankle sprains. And most importantly – they can continue to enjoy their daily, everyday activities.

Learn more about podiatry services available at Brookings Health System online at brookingshealth.org/Podiatry.