Ankle Instability Surgery: Broström Repair and What to Expect

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

When Ankle Instability Requires Surgery

Chronic lateral ankle instability — the condition of recurrent ankle giving way, repeated sprains, and ongoing insecurity with activity — develops in approximately 30-40% of patients who sustain significant lateral ankle sprains. Conservative treatment (physical therapy, bracing, proprioceptive rehabilitation) successfully manages most cases. When instability persists despite thorough conservative care — typically 6 months of appropriate rehabilitation — surgical ligament reconstruction becomes appropriate. At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, our surgeons perform anatomic ankle ligament reconstruction with excellent outcomes.

The Broström Procedure: Gold Standard Anatomic Repair

The modified Broström-Gould procedure is the standard surgical approach for lateral ankle instability in appropriate candidates. The stretched or torn anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) are identified, tightened, and repaired back to their anatomic insertions on the fibula. The inferior extensor retinaculum — a tissue band overlying the ligaments — is incorporated into the repair (the Gould modification) to reinforce the reconstruction. This anatomic repair restores the native ligaments rather than using tendon grafts, preserving normal ankle mechanics and sensory nerve fibers important for proprioception.

Who Is a Good Candidate

Ideal Broström candidates: failed conservative management including at least 4-6 months of physical therapy; confirmed ligamentous laxity on stress X-rays or clinical examination; absence of significant ankle arthritis (which would require additional or alternative procedures); body weight and activity level appropriate for the repair’s load-bearing capacity. Patients with generalized ligamentous laxity (hypermobility syndrome), previous failed Broström repair, or those who are very heavy may require augmented reconstruction using tendon graft rather than primary repair.

Recovery After Broström Repair

Typical recovery: non-weight-bearing in a splint for 2 weeks, then transition to weight-bearing in a boot at weeks 2-6, transition to an ankle brace and regular footwear at 6-8 weeks, physical therapy emphasizing proprioceptive retraining through 3-4 months, return to sport at 4-6 months. Full confidence with cutting sports and challenging surfaces typically occurs at 6-9 months. The Broström repair has excellent long-term outcomes with over 85% of patients reporting satisfactory stability at 10+ year follow-up. Contact Balance Foot & Ankle at (810) 206-1402 to discuss whether ankle instability surgery is appropriate for your situation.

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When to See a Podiatrist for Ankle Instability Surgery

The Brostrom repair is the gold standard surgery for chronic lateral ankle instability when bracing and physical therapy have failed. At Balance Foot & Ankle, Dr. Tom Biernacki performs both traditional and modified Brostrom procedures to restore ankle stability and prevent recurrent sprains.

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Clinical References

1. Brostrom L. Sprained ankles. VI. Surgical treatment of “chronic” ligament ruptures. Acta Chir Scand. 1966;132(5):551-565.
2. Bell SJ, Mologne TS, Sitler DF, et al. Twenty-six-year results after Brostrom procedure for chronic lateral ankle instability. Am J Sports Med. 2006;34(6):975-978.
3. Viens NA, Wijdicks CA, Campbell KJ, et al. Anterior talofibular ligament ruptures, part 1: biomechanical comparison of augmented Brostrom repair techniques with the intact anterior talofibular ligament. Am J Sports Med. 2014;42(2):405-411.

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Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.