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Innovative Solutions for the Business of Health Care Akron n Cleveland n Lorain County n www.brouse.com The challenges faced by health care providers may also be opportunities for growth and prosperity. This requires a comprehensive knowledge of the law, and a clear understanding of health care as a business. Brouse understands the operations, market trends and economics of the health care industry. It's more than legal advice, it's a business solution. For more information, please contact: Daniel Glessner, Esq., Practice Chair 330.535.5711 x316 | dglessner@brouse.com Christopher Huryn, Esq., Partner 330.535.5711 x389 | churyn@brouse.com David Schweighoefer, Esq., Partner 216.830.6830 x277 | dschweighoefer@brouse.com J. Ryan Williams, Esq., Partner 216.830.6830 x592 | rwilliams@brouse.com L AT E R A L A N K L E S P R A I N S a r e exceedingly common. Nea rly 40% of a ll sports injuries occur at the level of the a nk le joint. Unfor tunately, this seemingly simple injur y prog resses to chronic latera l a nk le instabi lit y in approxi- mately 20% of patients. A ssociated pat holog y, including peronea l tendon tea rs, osteochondra l defects of the a nk le joint, synovitis, ankle impingement, and even ankle arthrosis, a re common sequelae of a n unstable a nk le joint. Ea rly a nd a gg ressive f unctiona l physica l therapy ca n be benef icia l. However, in the case of true mecha nica l instabilit y, latera l collatera l ankle ligament reconstruction is usua lly necessar y. The Brostrum-Gould procedure is considered the anatomic repa ir of the latera l collatera l a nkle liga ment complex. This includes direct repa ir of the a nterior tibio-f ibula r liga ment that incorporates the latera l aspect of the ex tensor retinacu- lum into the repa ir. This provides for increased resista nce to hindfoot inversion a nd recurrent injur y. A lthough this procedure has shown excellent outcome measures, incisions ca n occa siona l ly approach 5 cm i n leng t h on t he latera l a nk le, possibly increasing surg ica l risk a nd post-operative recover y time. Over the last decade significant advances have been made in sma ll joint arthroscopy. In 2011, Acevedo and Mangone 1 introduced a novel technique that allows a surgeon to perform the Brostrum-Gould procedure through standard arthroscopic a nk le por ta ls. Follow-up studies demonstrated improved patient outcomes, and equivocal if not improved biomechanical streng ths of the repair. Similar to the ACL repair of the knee, the arthroscopic latera l ankle stabilization does shorten the time for patients to return to normal activity, significantly reduce scarring, and limit overall surgical risk. Estimated time to full functional recovery is approximately 3-4 months for isolated ligament repairs. Dr. Duane Ehredt is board qualified in Foot and Reconstructive Rearfoot/Ankle Surgery by the American Board of Foot and Ankle Surgery, and an Associate of the American College of Foot and Ankle Surgeons. He is an Assistant Professor in Foot and Ankle Surgery at Kent State University College of Podiatric Medicine in Independence, Ohio. ■ Reference 1. Acevedo, J.I., and Mangone, P.G., Arthroscopic lateral ankle ligament reconstruction. Techniques in Foot and Ankle Surgery. 2011. 10(3): 111-116. Arthroscopic Lateral Ankle Sprains: A Promising Future for a Difficult Injury BY DUANE J. EHREDT JR., DPM, A ACFAS 1 7 M D N E W S . C O M /// M D N E W S C L E V E L A N D /A K R O N / C A N T O N n S E P T E M B E R / O C T O B E R 2 016 C L I N I C A L S E C T I O N 1 7