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I am looking for some information about a type of procedure that a new patient (to me) had 6 months ago. His understanding is sketchy and therefore I have had trouble finding any info.

He "popped" his R/lateral ankle ligaments 20 yrs ago and underwent Sx earlier this year that he feels has been very successful. He thinks the surgery was called a "postrum/prostrum procedure" whereby the ligaments were attached to the fibula with permanent metal plates.

I thank you in advance for your help. :D

 

Brostrum.

Its a delayed primary repair of the ATF ligament.

LL

 

Never heard of a Postrum but certainly the Brostrum or Brostrum-Gould is a common procedure we perform for lateral ankle instability usually in conjunction with adjunctive procedure(s).
Having said that, there is no fixation involved with the fibula for this so its unlikely to be the one you mention (unless the plates were used as part of fibular fracture repair at the same time) an not necessarily the ligamentous repair.

Ryan

 

Thank you! Now I know the correct name I can see there is lots of information on this type of surgery.
He was quite definite on the metal plates though but I can see on Wheeless' Textbook that there is no plate to anchor the ligament(s).
I also note that the ankle is placed in dorsiflexion and valgus. This is certainly what I have seen clinically in a very brief appointment. He has come to see me via an exercise physiologist as he is experiencing 5th met (lat & dors) pain and EDL pain with running. Is this the norm? Otherwise I will treat him as a standard biomech case and assess his current orthoses and shoes and take it from there.

 

Hi Lisa, Perhaps the patient sustained a fracture of his fibular malleolus concomitant with his anterior talo-fibular ligment tear; necessitating a modified Brostrom procedure to repair and supplement the ATFL and a plate to stabilise the fibular malleolar fracture? Otherwise, I cannot imaging why a plate would be used in an ATFL repair. Cheers, Andrew.

 

Thanks for the information. I saw him again this morning and he definitely felt there were plates in there....I haven't seen the x-rays so I can't confirm or deny but at least I knew what I was dealing with.
Thanks for your help so I didn't look like a complete idiot ; )