Arthrobrostrom Lateral Ankle Stabilization Technique: An Anatomical Study

Abstract

To evaluate the proximity of anatomical structures for the Arthrobrostrom lateral ankle ligament stabilization and define ideal landmarks and “safe zone” for this repair. Ten matched-pair of human cadaveric ankle specimens were screened for the study. All specimens underwent arthroscopic lateral ligament repair according to the previously described Arthrobrostrom technique with two suture anchors in the fibula. Three cadavers were used to test our protocol and seven were dissected to determine proximity of anatomic structures. Several distances were measured including those of different anatomic structures to the suture knots in order to determine a “safe zone”. Measurements were obtained by two separate observers and statistical analysis was performed. None of the specimens revealed entrapment of the critical anatomic structures by either of the suture knots. The internervous “safe zone” between the intermediate branch of the superficial peroneal nerve (SPN) and sural nerve was a mean 48mm. The intertendinous “safe zone” between the peroneus tertius and peroneus brevis was a mean 43mm. On average, a 20mm safe distance was maintained from the most medial suture to the intermediate branch of the SPN. The amount of inferior extensor retinaculum grasped by either suture knot varied from 0mm to 8.7mm. The results indicate there is a relatively wide internervous and intertendinous “safe zone” when performing the Arthrobrostrom technique for lateral ankle stabilization. While none of the critical anatomic structures were entrapped by the suture knots it was evident that the inferior extensor retinaculum is included in a majority of the repairs. Our study further defines the proximity of adjacent anatomic structures and establishes the anatomic “safe zone” for the Arthrobrostrom lateral ankle stabilization procedure.