Modified Broström-Gould Lateral Ankle Stabilization: Technique and Long-Term Outcomes

Quick answer: Modified Brostrom Gould Ankle Instability Reconstruction Outcomes is a common foot/ankle topic that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.

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

Chronic lateral ankle instability — recurrent “giving way” of the ankle from incompetent ATFL and CFL ligaments — affects approximately 20–40% of patients after initial Grade III lateral ankle sprain and is a common indication for surgical reconstruction. The modified Broström-Gould procedure is the gold-standard anatomic repair for chronic lateral ankle instability, with a 30-year evidence base demonstrating excellent clinical outcomes and allowing return to sport in the majority of patients.

Anatomy and Pathomechanics of Chronic Instability

The anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) are the two ligaments primarily responsible for lateral ankle stability. After complete rupture, both are capable of spontaneous healing in most patients who complete structured rehabilitation. In 20–40% of patients, however, the ligaments heal in an elongated, lax configuration — producing persistent mechanical instability manifested as recurrent ankle sprains, “giving way” on uneven ground, and functional limitations in sport. Functional instability (subjective giving way without measurable laxity) and mechanical instability (objectively increased talar tilt on anterior drawer testing, MRI-confirmed ligament insufficiency) frequently coexist. Indications for surgical reconstruction: ≥6 months of symptoms despite structured rehabilitation including peroneal strengthening and proprioception training, recurrent instability limiting return to desired activity, and documented mechanical instability on stress radiographs or MRI.

Modified Broström-Gould Technique

The Broström repair (1966) directly sutures the attenuated ATFL and CFL back to the fibular origin through a curvilinear incision anterior to the fibula. Gould’s 1980 modification augments the repair with a flap of the inferior extensor retinaculum sutured over the top of the primary repair — providing an additional layer of restraint, incorporating the extensor retinaculum’s contributions to ankle stability, and acting as a biological patch that reinforces the ligament repair against early re-failure. The augmented (modified Broström-Gould) repair is now universally preferred over the original technique for its superior mechanical strength. Arthroscopic-assisted and all-arthroscopic modifications perform the repair through smaller portals, demonstrating equivalent outcomes to open repair in early studies with the advantage of simultaneous treatment of intra-articular pathology (synovitis, chondral lesions, loose bodies) that is present in over 50% of patients with chronic instability.

Outcomes and Return to Sport

Long-term follow-up series consistently demonstrate: 85–95% clinical success rates at 5–10 years (defined as absence of giving-way and return to desired activity level), 85–90% return to pre-injury sport level, minimal loss of ankle range of motion, low reoperation rates (< 5% for isolated instability without concurrent deformity), and durable patient-reported outcomes at 20-year follow-up in multiple series. Concurrent ankle arthroscopy at the time of Broström repair allows identification and treatment of intra-articular pathology that would otherwise limit recovery. Dr. Biernacki at Balance Foot & Ankle evaluates chronic ankle instability with stress radiographs, MRI, and clinical assessment, offering structured non-surgical care and surgical reconstruction when indicated. Call (810) 206-1402 for ankle instability evaluation.

When to See a Podiatrist

Many foot conditions can be managed conservatively at home, but some require professional evaluation. See a podiatrist promptly if you experience:

• Pain that persists for more than 2 weeks despite rest
• Swelling, redness, or warmth that isn’t improving
• Numbness, tingling, or burning in the feet
• A wound or sore that is not healing within 2 weeks
• Any foot concern if you have diabetes or poor circulation
• Nail changes that suggest fungal infection or other problems

At Balance Foot & Ankle, our three board-certified podiatrists — Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin — provide comprehensive foot and ankle care at our Howell and Bloomfield Township offices. Most insurance plans are accepted.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your ankle sprains, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.