The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
October 11, 2026 · via Europe PMC
High Infection Rate in Open Anterior Talofibular Ligament Repair with Internal Brace Augmentation and Immediate Permissive Weight Bearing.
Poon J, Lambert B, de Vries AJ, van Raaij TM.
AI summary — for doctors, generated from the abstract only
Open ATFL repair with internal brace augmentation and immediate weight bearing had a higher surgical site infection rate than repair without augmentation and with restricted rehabilitation.
What was studied
A retrospective cohort comparing 34 patients with internal brace augmentation (2022 to 2024) with 31 patients without augmentation (2016 to 2019), with surgical site infection within 90 days as the primary outcome.
Key findings
- SSI occurred in 5 patients (15%) with augmentation and none (0%) without (p = .034)
- Other complications were persistent instability (3%) and malposition (3%) in the augmentation group and knot pain (3%) in the other group
- Baseline characteristics and operative time were comparable, except for higher smoking prevalence in the non-augmented group
Clinical relevance
A caution for surgeons adopting internal brace augmentation to monitor infection rates and consider implant-related risk.
Who should care
Limitations
Small, historical-control comparison from different time periods; augmentation and rehabilitation changed together, so their separate effects cannot be determined. Few events.
A signal of higher infection with augmentation plus early loading, not a proven cause.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Modified Broström repair is the gold standard for chronic lateral ankle instability. Internal brace augmentation was introduced to increase ligament strength and allow earlier rehabilitation, but concerns exist regarding surgical site infection (SSI).
Purpose
To compare the incidence of SSI following anterior talofibular ligament (ATFL) repair with internal brace augmentation and immediate permissive weight bearing versus ATFL repair without augmentation and restricted rehabilitation.
Study design
Retrospective cohort study.
Methods
Patients undergoing open ATFL repair with internal brace augmentation and immediate permissive weight bearing (ATFL-IB group) between January 2022 and February 2024 (n = 34) were compared with patients undergoing open ATFL repair without augmentation and restricted rehabilitation (ATFL group) between January 2016 and March 2019 (n = 31). The primary outcome was SSI, defined as infection within 90 days requiring antibiotic therapy or surgical intervention. Secondary outcomes included other complications. Baseline characteristics and SSI-related risk factors were assessed.
Results
SSI occurred in 5 patients (15%) in the ATFL-IB group and none in the ATFL group (0%) (p = .034). Other complications included persistent ankle instability (3%) and malposition (3%) in the ATFL-IB group and knot pain (3%) in the ATFL group. Baseline characteristics and operative time were comparable, only smoking prevalence was higher in the ATFL group.
Conclusions
ATFL repair with internal brace augmentation and immediate permissive weight bearing was associated with a higher SSI rate compared with ATFL repair without augmentation and restricted rehabilitation. Because augmentation and rehabilitation differed concurrently, their relative contributions could not be determined.
DOI
10.1053/j.jfas.2026.10.008
PMID
42860173
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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