Lateral Ankle Instability

Ankle sprains are common injuries that often occur in the athletic population. Lateral ankle instability is a long-term complication from plantar flexion inversion stress and injuries to the ankle. Acute injuries should be graded appropriately based on examination and treated with nonsurgical functional treatment. Acute surgery for a grade 3 injury in the high-level athlete has been described and is an option, albeit without robust literature support currently. Chronic ankle instability without a history of conservative treatment should first undergo an appropriate course of physical therapy and bracing. Surgery is planned after ascertaining any risk factors for recurrent instability, including poor-quality tissue, previous surgery, generalized laxity or hypermobility, and cavovarus deformity. These risk factors should determine if concurrent procedures should be performed or if an anatomical reconstruction is appropriate. One must keep in mind that most patients can and should still be treated by an anatomical repair.