BROSTROM RECONSTRUCTION
PLEASE KEEP YOUR FOOT ELEVATED ABOVE YOUR HEART AS MUCH AS POSSIBLE FOR THE FIRST FEW WEEKS AFTER YOUR SURGERY
The Brostrom operation is a reconstruction of damaged ligaments on the outer – lateral - side of the ankle.
Why do you need a reconstruction?
If you have sprained your ankle in the past and your ankle keeps giving way, you would normally be prescribed a course of physiotherapy. If this does not improve the problem, and the ankle is still unstable, a Brostrom repair can be done to reconstruct the torn ligaments.
What does a Brostrom reconstruction involve?
You will have a general anaesthetic. A small incision is made on the outside of the ankle in order to locate the remains of the ankle ligaments. The ligaments are then fastened back into place using stitches or small screws. A plaster is then applied below the knee.
Occasionally, the ligament is so badly damaged, or the ends are so scarred, that it cannot be repaired. In that case, the ligament would be replaced with a piece of tendon from the outside of your ankle. It is rare to have to change from a Brostrom operation to a tendon operation, but it cannot always be predicted and you should be prepared for the possibility. The main difference is that a tendon operation may be tighter and a little stiffer, and in the long term the ankle may ache more. However, it is a very strong repair.
How long will I be in hospital?
If you are fit and healthy and someone can collect you and look after you after the operation, the operation can be done on a day case basis. However, if you have other medical problems, you may have to stay overnight after surgery.
What will happen afterwards?
You can go home when comfortable and safe, partially weight bearing on crutches.
Stage 1: 7 Days after surgery
You will be seen in the clinic and your plaster will be changed and the wound inspected. A new plaster will be applied and you can walk fully on this plaster once it is dry.
You can return to sedentary work once your ankle is comfortable, keeping it elevated as much as possible. If you do a heavy manual job, you may need 2-3 months off work.
Stage 2: 3 Weeks after surgery
The plaster will be removed in clinic and the ankle examined. If your ankle is healing well, you will be given a lightweight ankle brace to wear day and night. You can walk with your full weight on this.
Physiotherapy will be arranged to start getting your ankle moving again. You will go through another full course of physiotherapy to make your ankle strong and flexible, to get back peroneal muscle strength and to retrain the fine nerve endings in your ankle to give the right signals to the muscles around them. This will last for several months.
You are not allowed to turn your foot inwards for the next 6 weeks.
Stage 3: 8 Weeks after surgery
Remove the brace at night but it still needs to be worn during the day.
Stage 4: 10 Weeks after surgery
Cease using the brace during the day.
Stage 5: 3 Months after surgery
Commence exercise involving turning your foot inwards.
Stage 6: 4 Months after surgery
You may now cease wearing the brace for gym work. This may only involve inline movements (i.e. no twisting) and gentle impact work only.
Stage 7: 5 Months after surgery
You may return to contact sport but may be required to continue wearing the brace for a further 3 months depending on your chosen activity.
Returning to normal activities
Driving
If you have had your LEFT ankle repaired, you can drive an automatic car within a few days of the operation. Otherwise you will have to wait until the ankle is strong and flexible enough to work the pedals, especially in an emergency situation. This will probably not be for 5-6 weeks after surgery.
When you do commence driving again, it is best to start slowly and for short distances.
Don’t forget that if you start driving before you can stop or manoeuvre in an emergency, you insurance will not cover you in the event of an accident.
What can go wrong?
The ankle may continue to give way even with a good repair, which is not loose. This is because the small nerve endings in the ankle are not working well, the peroneal muscles have not recovered their strength or the Achilles tendon is tight. Physiotherapy usually improves this, but a few people keep wearing an ankle brace.
If you develop a fever associated with an increase in pain and a discharge from the wound please call Mr Williams’ secretary. If you have any questions please call Mr Williams’ secretary.
Thank you.
