Foot and Ankle Surgery

Ankle Instability

ankle instability radiograph

Recurrent ankle sprains (Ankle instability)

What is  ankle instability?

If an ankle is twisted easily and several times in daily life, then it is called as ankle instability . It is usually arisen after a severe ankle twist complicated with ankle ligament tears. In this initiative  ankle sprains, patients usually experience  severe pain and swelling.

What is the common cause of ankle sprains?

There are several ligaments that stabilize the ankle. Ankle sports trauma or frequent ankle sprains may cause tears of anterior talofibular ligament and calcaneofibular ligament.

The ligament injuries are classified in three groups according the  severity: 1 – ligament strain, 2 – partial ligament tear, 3 – complete tear of the ligament.If the third group injuries are not treated properly, may cause recurrent ankle sprains or ankle instability.

Do the ligament tears cause further damage?

Frequent ankle sprains not only cause decrease of functional success during sports activity and performance, also, the ankle can be vulnerable to the further  cartilage and bony injuries due to the instability.

What is the treatment of recurrent ankle sprains?

In the treatment of ankle sprains, conservative traetment like physical therapy is first treatment aproach. However, when conservative treatment  fails, surgical treatment may be opted.

Ankle ligament reconstruction surgery is applied in the following cases:

Recurrent ankle sprains and continued instability despite intense physical theraphy

loss of function

ongoing pain

What tests are done prior to the Ankle Ligament Reconstruction?

Before Ankle Ligament Reconstruction, physical examination and radiological analysis including MR should be performed.

In MRI study, both the main ligament rupture and the possible coexisting injury (cartilage damage, other ligament injury, and others) can  also be easily detached.

Is there a process of ankle Ligament Reconstruction accompanied with the ankle arthroscopy?

If there are;

The presence of concomitant pathology of radiography or MRI,

Ankle joint movement limitations,

The presence of unexplained pain Ankle,

simultaneously with the process of reconstruction, ankle arthroscopy is performed.

How is Ankle Ligament Reconstruction surgery performed?

Extensor retinaculum, peroneal tendon, or tendon auto and allografts are used in reconstruction.

Ankle Ligament Reconstruction using the extensor retinaculum process  known as Brostrom procedure is shown schematically below:

How long do I need to stay in hospital and when will I be able to start to walk?

After ankle ligament reconstruction surgery, the hospital stay isone night. Postoperatively, below knee cast is used for 4 weeks. patient can walk with crutches on the first postoperative day and is allowed to bear weight in 1 week.

How long it takes to do sportive activities after ankle ligament reconstruction surgery?

10-12 weeks after ankle ligament reconstruction surgery patients can return back to sports.

Key Words: ankle sprain, ankle instability, anterior talofibular ligamen, calcaneofibular ligament.


The material contained on the web page is for general informational purposes only and is not intended neither to be a substitute for professional medical advice nor to be used for medical diagnosis or treatment.

Please consult with Your physician or other healthcare professional for medical advice.

About the author

Prof.Dr. Seref Aktas