. 2016 Jul 25;5(4):e775–e780. doi: 10.1016/j.eats.2016.03.003

Table 1.

Pearls and Pitfalls of the Modified Arthroscopic Brostrom Procedure With Bone Tunnels

Pearls	Pitfalls
1. The associated intra-articular pathologies should be addressed. 2. The whole anterior surface of the lateral malleolus should be cleared up for proper positioning of the bone tunnel. 3. The bone tunnels should be convergent posteriorly to minimize the size of the posterior incision and avoid acute turn of the sutures at the posterior cortex of the lateral malleolus and abrasion of the suture by the sharp edge of the posterior drill holes. 4. The guidewire should pierce the skin just lateral to the Achilles tendon. 5. Any hindfoot and ankle varus deformity should also be corrected.	1. Repair is not suitable if the quality of the ligament remnant is suboptimal. Ligament reconstruction should be considered. 2. It is not suitable if concomitant subtalar instability exists.

Pearls

Pitfalls

1.
The associated intra-articular pathologies should be addressed.
2.
The whole anterior surface of the lateral malleolus should be cleared up for proper positioning of the bone tunnel.
3.
The bone tunnels should be convergent posteriorly to minimize the size of the posterior incision and avoid acute turn of the sutures at the posterior cortex of the lateral malleolus and abrasion of the suture by the sharp edge of the posterior drill holes.
4.
The guidewire should pierce the skin just lateral to the Achilles tendon.
5.
Any hindfoot and ankle varus deformity should also be corrected.

1.
Repair is not suitable if the quality of the ligament remnant is suboptimal. Ligament reconstruction should be considered.
2.
It is not suitable if concomitant subtalar instability exists.