Pearls & Pitfalls
1. Use resorbable sutures. The time to resorption of the sutures is long enough to heal the reconstruction. In addition, unresorbable sutures can cause irritation.
2. Tighten the sutures with the foot in eversion. Since it is an anatomical reconstruction, it can never be too tight.
3. Laxity can remain when the sutures are initially knotted at the posterior tip of the fibula. To secure a tight reconstruction, pull the ligament remnants tight over the denuded fibula tip (picture)
4. Pull the ligament remnants tight over the denuded fibula tip to secure the reconstruction. A tight reconstruction has been achieved