Reconstruction Surgery For The Unstable Ankle

The ankle lateral ligament reconstruction surgery is performed though a small 2cm incision over the tip of the fibula. The ligaments are shortened and reinserted into the fibula with the aid of 2 small bony anchors. The anchors stay in the tip of the fibula permanently unless it causes irritation. Local anaesthetic is injected around the incision site. This usually provides good pain relief for up to 6 hours after the operation. There is some increase in pain after the local anaesthetic wears off at which time tablets by mouth will usually provide sufficient pain relief.

At the end of surgery, a bulky dressing is applied. An ankle stirrup brace (Fig 1) would also be applied. The bulky dressing should remain in place for 2 weeks as this provides cushioning against the pressure of the brace on the wound. During this time the dressing should be kept dry. The ankle stirrup brace needs to be worn whenever walking but may be taken off when the patient is sitting or in bed.

Formal physiotherapy exercises commence 2 weeks after the operation. A physiotherapy protocol is provided for the patient’s physiotherapist. Dr Lam reviews patients 2 weeks after the surgery. A short walking boot (Fig 2) is used when walking until 6 weeks after the surgery to protect the lateral ligament reconstruction.

The timing of returning to work and sport will depend on the type and severity of any associated ankle joint problem that is being treated and the type of work and sport involved. Dr Lam is able to provide an indication of the expected return to work and sport prior to surgery.