Percutaneous Chrisman-Snook Double Ankle Ligament Repair with Suture Anchors A Case Series and Surgical Technique

Lateral ankle sprains, if a candidate for surgical repair, are classically repaired with a Brostrom or Brostrom-Gould approach with numerous modifications that have included open or arthroscopic repair. However, many patients with significant instability require a double ligament repair to the anterior talo fibular ligament (ATFL) and calcaneofibular ligament. (CFL)To date, this has most successfully been repaired with an open Chrisman-Snook procedure with use of a split peronealbrevis tendon or allograft. The present study examines n= 12 patients with lateral ankle instability who underwent a double ankle ligament repair with suture anchors performed percutaneously. The patients were followed up for a mean of 24.2 (8-38) months. The mean time to full weight bearing was initiated at a mean of 21.3 (18-29) days. All patients participated in physical therapy by week 4. They were transitioned into an ankle stabilizing orthosis brace on average of 3.5 weeks. Overall, there were only 4 reported post-operative complications including suture reaction, 2 cases of neuritis, and a DVT. We have shown that patients with a minimally invasive percutaneous technique have an improved post-operative recovery in terms of pain, functional outcome and clinical outcome and may begin weight bearing earlier than previously studied. To review a novel approach including surgical technique to double ankle ligament repair with suture anchors in a percutaneous fashion