What is an Ankle Sprain?
A sprain is the stretching or tearing of ligaments, which connect adjacent bones and provide stability to a joint. An ankle sprain is a common injury that occurs when you suddenly fall or twist the ankle joint or when you land your foot in an awkward position after a jump. Most commonly it occurs when you participate in sports or when you jump or run on a surface that is irregular.
Indications for Tendon Reconstruction?
Surgery is recommended in patients with a high degree of ankle instability and in those who have failed to respond to non-surgical treatments.
Tendon Reconstruction Procedure
Tendon reconstructionis a tendon transfer procedure that uses your own tendon or a cadaver tendon as a graft to replace the damaged tendon. The surgery is performed under epidural anesthesia. Your surgeon makes an incision on your ankle. Drill holes are created where the damaged ligament normally attaches to the lower end of the fibula (calf bone) on one side and the talus (anklebone) on the other end. Your surgeon then harvests the peroneus brevis muscle tendon, found on the outer edge of the small toe, and weaves it through the drill holes to form a ligament complex. Range of motion is evaluated; the incision is closed, and a sterile bandage is applied.
Postoperative Care for Tendon Reconstruction
After surgery, your foot will be immobilized with a cast or splint. You will be provided crutches to avoid bearing weight on the operated ankle. Your doctor will remove the splint and provide a removable boot to be worn for 2 to 4 weeks. Physical therapy will be initiated to strengthen your joint and improve range of motion. Complete recovery may take 10 to 12 weeks.
Advantages and Disadvantages of Tendon Reconstruction
The advantages of tendon reconstruction include:
- Provides increased strength
- Can be used when host tissues are severely damaged
- Provides additional stability in obese patients
The disadvantages of tendon reconstruction include:
- Decreased rear foot motion
- Does not preserve the peroneus brevis, an important structure for the ankle’s dynamic stability
Risks and Complications of Tendon Reconstruction
As with all surgical procedures, tendon reconstruction may be associated with certain complications including:
- Injury to the superficial nerves
- Chronic pain
- Need for second surgery (rare)