PMC8702971_01
Lateral anchor insertion at the lateral malleolus as described by Nery et al

 and Acevedo and Mangone.
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A traditional arthroscopic Brostrom was performed, using an anchor and suture passers as previously described.   Sutures were passed but not tightened (Figure 1).
Medial anchor insertion at the medial malleolus quadrant as described by Vega et al.
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A medial anchor was inserted at the medial malleolus, in the quadrant described by Vega et al   (Figure 2).
Sutures are passed using an inside-out technique for both ligament complexes. A "Spider Web" configuration is obtained and arthroscopic knots implemented.
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Finally, the medial repair was finalized by tightening the deltoid sutures with the ankle still in neutral position (Figure 3).
Weightbearing anteroposterior ankle radiograph from a patient submitted to the described technique and 12 months of follow-up.
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Full return to competitive activity was allowed by the fifth postoperative month (Figure 4).