A Novel Percutaneous Modified Brostrom-Gould Technique for Lateral Ankle Instability Using the Lasso Technique

Abstract

We describe a percutaneous modification of the Brostrom-Gould procedure for lateral ankle instability. Our surgical technique involves making a stab incision at the anterior aspect of the distal fibula. Dissection is made down to bone and a double-loaded suture anchor is placed at the anterior talofibular ligament (ATFL) origin. The sutures are loaded individually onto a trocar needle and passed underneath the remnant ATFL and inferior extensor retinaculum at its distal extent. Percutaneous stab incisions are made to allow retrieval of the sutures which are passed subcutaneously back to the ATFL origin. The 2 sets of sutures, positioned to reconstruct the ATFL and calcaneofibular fibular ligament, are then secured with the ankle in eversion and plantigrade position. Patients are placed on a short walker boot and 2 to 3 weeks of non–weight-bearing postoperatively. Level of Evidence: Level V—Expert opinion. See Instructions for Authors for a complete description of levels of evidence.