Fig 6.

(A) The suture retriever grasps the suture loop together with the graft loop out of the fibular tunnel. The suture loop acts as a pulley. The graft glides on the suture loop and becomes tightened as the opposite end of the graft outside the calcaneal tunnel is manually tensioned. (B) Suspension fixation of the graft loop in the fibular bone is achieved by Endobutton when the ankle is placed at neutral position in the sagittal plane and 10° of eversion. (C) The calcaneal side fixation of the calcaneofibular ligament is achieved by an interference screw inserted from portal 4 while viewing at portal 2. (D) Care is taken to prevent screw head protrusion leading to peroneus tendon irritation. (CFL, calcaneofibular ligament; EB, Endobutton; FT, fibular tunnel; GL, graft loop; P2, portal 2; P4, portal 4; SH, screw head; SL, suture loop; SR, suture retriever.)