Broström surgery is a surgical procedure that was first introduced in the 1960s. The Broström surgery is performed to stabilize the ankle if it has suffered repeated sprains, strains, or is otherwise vulnerable to being twisted or injured. The Broström has been modified over the years into the procedure that is currently performed, but the basic idea of surgical stabilization of the ankle has been in use for half a century.
The foot is held to the leg by a number of joints, tendons, and muscles. The tendons of the foot and leg give the ankle joint great flexibility and permit the foot to move in many directions under great force. Unfortunately these tendons can becomes stretched, pulled, or torn leaving the foot and ankle vulnerable to abnormally large ranges of motion and further joint injury. While the first treatment for recurrent ankle sprains would be a comprehensive physical therapy rehabilitation program, if this fails a Broström surgery is used to repair the tendons of the ankle joint.
A Broström repair is specifically for the tendons of the lateral ankle, that is, the tendons of the outer ankle near the foot. If you reach down and touch the protruding bone on the outside of the ankle, the tendons just between this bone and the foot stabilize the ankle. These lateral tendons-the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL)-are what keep the foot from rolling inward and the leg from rolling outward. These tendons are also the focus of the Broström procedure.
In the original Broström surgery, the anterior talofibular ligament (ATFL) was shortened and repaired and, in some patients, the calcaneofibular ligament (CFL) was also repaired. This shortening of the tendon holds the bones of the ankle joint in place similar to tightening down the straps on cargo hauled on a truck. The original series of patients in which this report was based was very successful-eighty percent of patients enjoyed success with the Broström repair.
In the 1980s, a surgeon by the name of Gould made alterations to the Broström surgery. This increased the success rate and expanded the number of patients that could be treated with this surgical approach. In the Gould-Broström surgery or the Modified Broström surgery, a tough, fibrous tissue called the extensor retinaculum is folded over the lateral ankle joint in order to further stabilize it. This approach and subsequent modifications like the Chrisman-Snook modification have been particularly successful in ballet dancers who suffer repeated stresses to the ankle joint and often require surgical ankle stabilization.
The Broström surgery may be performed by orthopedic surgeons or podiatrists that routinely perform specialized surgery. The Broström surgery is usually reserved for patients that have failed physical therapy rehabilitation and who have loose ligaments/tendons. With increased stability after the procedure, there may also be a reduced range of motion (as compared to before the ankle injury). This can be overcome to some degree with physical therapy and conditioning but should not be pursued too aggressively because it could jeopardize the stability of the joint over time.