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  • 1. Anatomic Landmarks
  • 2. Incision
  • 3. Dissection
  • 4. Bone Preparation
  • 5. Repair
  • 6. Closure
  • 7. Apply Posterior Splint
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Brostrom-Gould Procedure for Lateral Ankle Instability


Eric Bluman, MD, PhD
Brigham and Women's Hospital

Main Text


Acute ankle sprains are most frequently treated conservatively, although some surgeons may advocate acute repairs in certain situations. Surgery is indicated for chronic sprains with persistent ankle instability despite well-designed conservative management. Several anatomic and nonanatomic operative procedures are available. The Brostrom-Gould procedure is a widely-used operative intervention for treatment of chronic lateral ankle sprains. It consists of an anatomic repair or reconstruction of the injured lateral ankle ligament complex (Brostrom procedure), followed by suturing of the inferior extensor retinaculum to periosteum of the distal fibula (Gould modification).

This article describes the standard Brostrom-Gould procedure starting with the identification of the anatomic landmarks. The skin incision follows the anterior border of the distal fibula, and careful subcutaneous dissection is carried out to expose the extensor retinaculum and the torn ligaments. This is followed by bone preparation and ligament repair utilizing a box stitch technique while holding the ankle in an appropriate position. Finally, the Gould portion of the procedure is demonstrated.

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This article is the companion to the JoMI articles: