Chronic “rolling” ankles are usually the legacy of a sprain that never fully healed. In many cases the anterior-talofibular ligament (ATFL) and calcaneofibular ligament (CFL) have stretched but remain repairable. A Broström reconstruction tightens these native ligaments and reinforces them with nearby retinaculum—restoring the ankle’s factory stability without implants or tendon grafts.
| Must-Have Findings | Notes |
|---|---|
| ≥ 6 months symptomatic laxity | Recurrent giving-way despite brace & PT |
| Positive anterior-drawer / talar-tilt | Confirmed under anaesthesia or stress X-ray |
| Good-quality ligament tissue on MRI | Not shredded or scarred beyond repair |
| Flexible hind-foot alignment | No rigid cavus or varus that would re-stress the repair |
| Phase | Boot / Weight-Bearing | Rehab Focus |
|---|---|---|
| 0-2 wk | Posterior splint, NWB | Elevation, edema control |
| 2-4 wk | CAM boot WBAT | Ankle ROM (dorsiflex/plantar-flex) |
| 4-8 wk | Lace-up brace in sneaker | Theraband inversion/eversion, bike |
| 8-12 wk | Brace only for sport drills | Proprioception, single-leg hops |
| 3-4 mo | No brace for daily life | Agility ladder, return-to-run test |
Clearance for pivot sports once hop-test & Y-balance ≥ 90 % of contralateral limb.
| Metric (systematic review, 2023) | Result |
|---|---|
| Re-rupture / persistent instability | 5 % |
| Return to recreational sport | 90-95 % at 4-6 mo |
| Numbness / scar sensitivity | ≤ 3 % (usually transient) |
| Patient satisfaction | > 90 % good-excellent |
| Benefits | Mitigation of Risks |
|---|---|
| Uses native ligament—no graft harvest | Temporary lateral-foot numbness (< 3 %) avoided by careful dissection |
| Keeps proprioception & natural feel | DVT prophylaxis (ASA) during NWB |
| Small scar, outpatient, rapid rehab | Re-sprain if PT ignored—structured program supplied |
| Proven > 50 yrs of durable results | Over-tightening rare with anatomic tensioning |
No hardware is implanted; just strong, permanent suture.
Left foot: 7-10 days. Right foot: once in a sneaker and off narcotics (≈ 3 wks).
We recommend a lace-up brace or tape for the first sports season; daily walking eventually needs no support.
If an ankle that “just keeps rolling” is limiting your sport or work, a classic Broström repair can restore lifelong stability—without implants or donor grafts. Book a stability evaluation with North Texas Podiatry Associates to learn whether this time-tested solution is right for you.