Ligament Augmentation with the Internal Brace

The surgical decision making and considerations when preparing to undertake an anatomic ligament repair with augmentation using the Internal Brace are described in this chapter. The Internal Brace supports early mobilization of the repaired ligament and allows the natural tissues to progressively strengthen. The principle established by this experience has resulted in its successful application to other foot and ankle ligaments including the deltoid, spring and syndesmosis complexes as well as other locations including the knee, shoulder, elbow and hand. The key benefits relate to reduced surgical morbidity, and the avoidance of detrimental effects of immobilization. This has transformed the patient experience. For over 30 years, the accepted orthopaedic approach to join instability secondary to ligament injury has been reconstruction with allograft or autograft in both the acute and chronic situation. with Internal Bracing principles and the evolution of technology, we have been able to successfully return to ligament repair.