Abstract
The more than 80 procedures described for chronic lateral ligamentous instability generally are divided intoanatomic and nonanatomic procedures or augmented and nonaugmented procedures. Of the anatomic repairs, the modified Broström is currently the most commonly used. It is indicated for most chronically unstable ankles. Relative contraindications include generalized ligamentous laxity, previous reconstructive procedures, and lengthy time from the original injury. The Chrisman-Snook and Watson-Jones procedures are nonanatomic, augmented reconstructions in which a portion of the peroneus brevis is used to reconstruct the ATFL (Watson-Jones) or the ATFL and CFL (Chrisman-Snook). Indications for these procedures have included patients with combined ankle and subtalar instability, obese patients, athletes at high risk for repetitive rotation and varus ankle stresses (such as football linemen), patients with connective tissue disease (such as Ehlers-Danlos syndrome), and patients with failed direct (anatomic) repair.
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