A small incision (cut) is made along the outside of the ankle and the injured lateral ligaments assessed. If a ligament has been stretched but not torn, it is cut and shortened, then the two ends are sewn together. If a ligament is torn but still remains attached to the fibula bone, the ends are repaired and sewn together.

If a ligament is found to have pulled away from the fibula, it must be reattached. Sutures (stitches) are used to attach the ligament to a small hole drilled in the fibula.

The extensor retinaculum (a band of tissue that crosses the front of the ankle joint) is used to reinforce the repair. A portion of it is pulled over the repair and sewn onto the fibula. This also helps to increase the stability of the ankle joint.

At the end of the procedure the incision is closed with a dissolving suture and steristrips on top of the skin. Plaster splints are applied until the swelling has disappeared. After a few days a short leg walking plaster cast is applied for three to four weeks.

What are the risks?

Below is a guide to the risks of this type of surgery. However, your surgeon will discuss these with you before your procedure, and answer any questions you may have:

• Infection
• The chance of infection is around 1% and can usually be treated with antibiotics
• Nerve damage
• Small nerves that supply feeling to the skin near the operation site can be damaged, although the risk is very small (around 5%). If your toe stays numb after surgery, the nerve may be bruised but will usually recover
• Further instability
• The risk of having further ankle instability following this procedure is low (around 5%) and further rehabilitation goals can be set with physiotherapy. However, if necessary, further surgery can be carried out
• Deep Vein Thrombosis (DVT)
• You may be given blood-thinning medication after the surgery if you are at a higher risk of DVT (where a blood clot forms in a deep vein in the leg). However, the risk of DVT after this procedure is less than 3% and may be reduced if you keep your ankle moving and carry out the recommended exercises