Lateral Ankle Ligament Anatomy
The lateral (outer) ligament complex is formed by three distinct ligaments.
- Anterior talofibular ligament (ATFL)
- Runs from the talus to the anterior (front) part of the tip of the fibula
- Calcanofibular ligament (CFL)
- Runs from the calcaneus (Heel bone) to the inferior tip of the fibula
- Posterior talofibular ligament (PTFL)
- Runs from the posterior (back) part of the talus to the posterior fibula.
What does ankle stabilisation surgery involve?
Utilising modern techniques, ankle stabilisation surgery is frequently performed as a day procedure.
You will arrive at the Hospital 1-2 hours prior to the schedule time of your procedure. You will be met by the anaesthetist and your analgesia options will be discussed. Typically, an anaesthetic ‘block’ is performed to maximise your pain relief following the procedure.
There are usually two parts to this procedure
Ligament Stabilisation / Ankle stabilisation surgery
A small incision is made directly over the torn ligaments of the lateral (outer) ankle. These ‘stretched’/’torn’ ligaments are reflected off the lower end of the fibula, and repaired with appropriate tension to restore function. Dr. Smith also often recommends a non-absorbable suture ‘brace’ is inserted to provide additional stability to the surgical repair.
Loose fragments of bone may be removed at the same time. The peroneal tendons (tendons behind the fibula) are inspected for any inflammation or tears which are addressed through the same incision.
An Ankle arthroscopy is performed to assess for evidence of synovitis (inflamed joint lining) and damage to the joint surface. This is performed through two tiny 3-5mm incisions over the front of the ankle joint.
Ankle stabilisation surgery – Rehabilitation
Following hospital discharge you will be fitted with a specialised boot. You are able to weight bear immediately, however you may find that the use of crutches for 1-2 days will be beneficial.
During the first week after surgery, keeping your leg elevated where possible will reduce postoperative swelling.
For the first 4 weeks, a dedicated program is commenced to focus on ankle and hindfoot range of motion, with calf strengthening and peroneal muscle strengthening.
Further strengthening and proprioceptive training is conducted from 4-8 weeks. Following this, the commencement of training and sport specific exercises may commence in conjunction with physiotherapy supervision.