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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2025; 16(12): 114166
Published online Dec 18, 2025. doi: 10.5312/wjo.v16.i12.114166
Published online Dec 18, 2025. doi: 10.5312/wjo.v16.i12.114166
Percutaneous anterior talofibular ligament repair: A new technique for chronic ankle instability
Mohamed M Elalfy, Department of Orthopedic Surgery, Mansoura University, Mansoura University Hospitals, Mansoura 35516, Egypt
Mohamed M Elalfy, Department of Orthopedic Surgery, Andalusia Health, Jeddah 22341, Makkah al Mukarramah, Saudi Arabia
Osama M Embaby, Department of Orthopedic Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham B66 2QT, United Kingdom
Osama M Embaby, Department of Orthopedic Surgery, Damietta University, Damietta 34511, Egypt
Mahmoud M Mekkawy, Department of Orthopedic Surgery, Andalusia Hospital, Jeddah 21433, Makkah al Mukarramah, Saudi Arabia
Ameer A Sayed, Department of Orthopedic Surgery, King Fahad Armed Forces Hospital, Ministry of Defense, Jeddah 23311, Saudi Arabia
Mohammed H Abushal, Department of Orthopedic Surgery, University of Tabuk, Tabuk 71491, Saudi Arabia
Author contributions: Elalfy MM designed the research and performed the surgeries and clinical work; Elalfy MM, Embaby OM, Mekkawy MM, and Sayed AA reviewed and edited the manuscript; Elalfy MM and Abushal MH supervised the study; Embaby OM curated, analysed the data and wrote the original draft. All authors have read and approved the final manuscript.
Institutional review board statement: The requirement for formal ethical approval was waived by the Institutional Review Board of Red Crescent Hospital, Mansoura, Egypt, as this was a retrospective case series of anonymized data. The study was conducted in accordance with the principles of the Declaration of Helsinki.
Informed consent statement: Written informed consent was obtained from all patients involved in the study.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohamed M Elalfy, MD, Foot and ankle surgery consultant, Department of Orthopedic Surgery, Mansoura University, Mansoura University Hospitals, El-Gomhoria Street, Mansoura 35516, Egypt. drmelalfy@mans.edu.eg
Received: September 15, 2025
Revised: September 27, 2025
Accepted: October 28, 2025
Published online: December 18, 2025
Processing time: 95 Days and 7.8 Hours
Revised: September 27, 2025
Accepted: October 28, 2025
Published online: December 18, 2025
Processing time: 95 Days and 7.8 Hours
Core Tip
Core Tip: The totally percutaneous modified Broström repair preceded by diagnostic ankle arthroscopy and confirmed by intraoperative stress views, offers a safe and effective minimally invasive alternative for chronic anterior talofibular ligament tears unresponsive to at least 3 months of conservative management. This technique minimizes soft tissue trauma, reduces operative time, and promotes faster recovery with excellent cosmetic and functional outcomes, making it particularly beneficial for active patients aiming for a quicker return to sports and daily activities. This case series demonstrates significant improvement in functional scores and resolution of instability at 18-month follow-up, highlighting its potential as a preferred surgical option.