J Korean Foot Ankle Soc.  2020 Jun;24(2):98-101. 10.14193/jkfas.2020.24.2.98.

Broström Procedure and Fibula Periosteal Turn Down Augmentation for the Ball-and-Socket Ankle Accompanying Lateral Ankle Instability: A Case Report

• Shin W
• Cho HM
• Park J

• KMID: 2502917
• DOI: http://doi.org/10.14193/jkfas.2020.24.2.98

Abstract

We report on the case of a patient with chronic instability of the ball-and-socket ankle joint. The patient, a 21-year-old male, was diagnosed 10 years previously with chronic instability of the ball-and-socket ankle joint. He underwent Broström procedure and augmentation using a periosteal turn down from the fibula for this chronic instability despite having received conservative treatment since the diagnosis. After the procedure, the clinical symptoms of ankle instability were improved and the patient is being periodically followedup. We report on this case of using a Broström procedure as a treatment option for patients with instability of the ball-and-socket ankle joint with normal range of foot and normal ankle joint alignment without damage in the joint and cartilage.

Keyword

Ball-and-socket; Round talus; Lateral ankle joint instability; Broström

Figure

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  Figure. 1 Right ankle anteroposterior (A) and lateral (B) radiographs of a 21-year-old male patient show ball-and-socket ankle joint. Talocalcaneal coalition posterior to talocalcaneal joint is suspected in right ankle lateral radiograph (B).

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  Figure. 2 (A, B) On right ankle anteroposterior radiographs with varus stress, talar tilt larger than 15 degree can be found (C, D) and right ankle lateral radiographs with anterior stress, anterior displacement larger than 10 mm can be found.

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  Figure. 3 (A, B) Axial and coronal T1-weighted images show neglected rupture of anterior talofibular ligament and calcaneofibular ligament. (C) Coronal T2-weighted image shows partial talocalcaneal coalition and increased signal in the medial side of subtalar joint.

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  Figure. 4 (A) Intraoperative finding shows neglected rupture of anterior talofibular ligament and calcaneofibular ligament. Black arrow shows ruptured anterior talofibular ligament. (B) We marked line in consideration of anatomical location and direction of each ligament to turn down fibular periosteal flap. Black arrow heads show reconstructed fibular periosteal flap for ruptured calcaneofibular ligament and white arrow heads show flap for ruptured anterior talofibular ligament. (C, D) Postoperative ankle stress radiographs show no ankle instability on varus stress.

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