Lateral Ankle Ligament Repair — Ankle Reconstruction — Modified Broström

SOMOS (Society of Military Orthopaedic Surgeons) · Tri-Service Orthopedics & Physical Therapy Consultants

Weight-Bearing

Wks 0-2: NWB in splint/SLC; Wks 2-4: WBAT (no passive PF stretching); Wks 4-6: WBAT in CAM boot → FWB; D/C crutches 3-5 weeks when gait WNL

Key Restrictions

NWB wks 0-2; no inversion PROM/AAROM past neutral first 4 weeks; no passive PF stretching wks 2-4; CAM boot until 6 weeks; no submerging 4 weeks; no running until 3 months; discharge criteria: FAAM sport >95%/ADL >88%, multiple hop test + Y-balance >90%, isokinetic >85%

Timeline & Phases

Phase 1 (wks 0-6): NWB wks 0-2 → WBAT wks 2-6 in CAM boot; no INV past neutral 4 wks; no passive PF stretching wks 2-4 — hip/knee AROM, intrinsic foot, OKC strengthening, eversion isometrics, ankle ROM (alphabet, circles, wobble board), weight shifts/proprioception, DL squats 0-45° (wks 3-6), pool after healed; Phase 2 (wks 7-12): ankle brace PRN, no running until 3 months — elliptical/bike/swimming, gastroc/soleus stretching, progressive hip/knee strengthening, ankle theraband, heel raise DL→SL, gait training, step-downs 4"→progress, squats, monster walks, progressive DL→SL balance, bilateral jumps → plyometrics wks 11-12; Phase 3 (wks 13-26): ankle brace for sport/agility — SL heel raises, progressive LE strengthening, jogging wks 13-16 (10-20%/wk), jumping/hopping progression (lateral, multi-planar, unilateral), plyometrics and agility drills wks 17-26; Discharge: multiple hop test + Y-balance >90%, isokinetic >85%, iPRRS >50%, FAAM sport >95%/ADL >88%; RTS aggressive military training 6-9 months

Notes

Tri-Service guidelines (Army/Navy/Air Force); published May 2020; military population; discharge criteria include FAAM sport >95% and Y-balance + multiple hop test >90%; RTS aggressive military training 6-9 months

Surgeon / Author

Tri-Service Orthopedics & Physical Therapy Consultants

Published

2020