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

Chronic lateral ankle instability — recurrent ankle sprains, persistent lateral ankle laxity, and functional giving-way despite rehabilitation — affects approximately 40% of patients following acute lateral ankle sprain and significantly impairs athletic participation and quality of life. When functional rehabilitation (peroneal strengthening, proprioceptive training, bracing) fails to provide adequate stability for desired activities, the modified Broström-Gould procedure provides anatomic reconstruction of the lateral ankle ligaments with reliable return to activity at 6 months.

Anatomy and Pathomechanics of Instability

The lateral ankle is stabilized by three ligaments: the anterior talofibular ligament (ATFL — the weakest and most commonly torn), the calcaneofibular ligament (CFL — torn in moderate to severe sprains), and the posterior talofibular ligament (PTFL — rarely torn except in complete dislocations). Mechanical instability: the ATFL and CFL are elongated or torn and provide inadequate restraint to talar inversion and anterior talar translation — demonstrated clinically by a positive anterior drawer test and positive talar tilt test. Functional instability: neuromuscular deficits (impaired peroneal reaction time and proprioception) produce giving-way without measurable mechanical laxity — treated with rehabilitation rather than surgery. Combined: most chronic ankle instability patients have both mechanical laxity and neuromuscular deficits — surgery addresses the mechanical component while rehabilitation addresses the neuromuscular component.

Broström-Gould Procedure and Outcomes

Technique: curvilinear incision anterior to the lateral malleolus; ATFL and CFL identified and imbricated (shortened and tightened) by advancing the proximal end of each ligament with suture anchors into the fibula — restoring anatomic length and tension; the inferior extensor retinaculum (IER) is advanced over the repair (the Gould modification) — augments the lateral repair and addresses subtalar instability. Arthroscopic-assisted Broström: ankle arthroscopy performed first to identify and treat intra-articular pathology (chondral lesions, anterolateral impingement — present in 25–40% of chronic instability patients) before open ligament repair. Outcomes: 85–95% successful return to sport at 4–6 months; 5–10% recurrence at 5 years; excellent long-term function in appropriate candidates. Dr. Biernacki at Balance Foot & Ankle evaluates chronic ankle instability with clinical stress testing and MRI and performs the Broström-Gould procedure for appropriate candidates. Call (810) 206-1402 at our Bloomfield Hills or Howell office.

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Frequently Asked Questions

How do I know if I sprained or broke my ankle?

Both cause pain, swelling, and difficulty walking. Key differences: fractures often cause more immediate severe pain, tenderness directly over bone (not just ligament), and inability to bear any weight. X-rays and the Ottawa Ankle Rules help determine if imaging is needed.

How long does an ankle sprain take to heal?

Grade I (mild): 1–2 weeks. Grade II (moderate): 3–6 weeks. Grade III (complete tear): 2–3 months. Chronic instability from improperly treated sprains can persist and may require surgery.

What is the best treatment for a sprained ankle?

RICE protocol (Rest, Ice, Compression, Elevation) for the first 48–72 hours, followed by protected weight-bearing as tolerated. Physical therapy rehabilitation is critical for high-grade sprains to restore strength and proprioception and prevent chronic instability.

Need Treatment at Balance Foot & Ankle?

Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.

Book Online or call (810) 206-1402

Broström-Gould Ankle Repair in Michigan

Balance Foot & Ankle performs the Broström-Gould procedure — the gold standard for chronic lateral ankle instability. Our surgeons restore ankle stability with proven surgical technique.

Learn About Our Ankle Instability Treatments → | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Bell SJ, et al. Results of the modified Broström procedure for lateral ankle instability. Foot Ankle Int. 2006;27(1):19-22.
2. Li H, et al. Comparison of arthroscopic and open Broström repair: a systematic review and meta-analysis. Int J Surg. 2017;46:80-89.
3. Maffulli N, et al. The Broström-Gould procedure for chronic lateral ankle instability: a long-term follow-up study. J Bone Joint Surg Am. 2018;100(14):1214-1218.