Compared with the open procedure, arthroscopic ATFL repair with IER reinforcement for LIA had an equivalent clinical result at the 1-year follow-up and allowed early recovery after surgery.
Although several arthroscopic surgical techniques for the treatment of lateral instability of the ankle have been introduced recently, some concern remains over their procedural complexity, complications, and unclear clinical outcomes. We have simplified the arthroscopic technique of Broström repair with Gould augmentation. This technique requires only two small skin incisions for two ports (medial midline and accessory anterolateral ports), without needing a percutaneous procedure or extension of the skin incisions. The anterior talofibular ligament is reattached to its anatomical footprint on the fibula with suture anchor, under arthroscopic view. The inferior extensor retinaculum is directly visualized through the accessory anterolateral port and is attached to the fibula with another suture anchor under arthroscopic view via the anterolateral port. The use of two small ports offers a procedure that is simple to perform and less morbid for patients.
Patients in group A returned to full athletic activity 5 weeks earlier than those in group I, demonstrating the advantage of accelerated rehabilitation after surgery.
The procedure, which can achieve anatomical reconstruction of the AITFL easily, seems to be one possible treatment for chronic disruption of the distal tibiofibular syndesmosis after PER stage 4 injury including avulsion fracture of the posterior malleolus, which is most common in this type of injury.
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