Dr. Oster, Can you please explain the reasoning behind being NWB for 6 weeks after a Brostrom. I am following my doctors orders, just forgot to ask why. Just curious. Thanks

Good question. I was just reading Brostrom's original article from 1966 and he walked folks in plaster casts 3 days post-op.

My philosophy is that I'm intentionally creating scar tissue at the site of the attenuated (stretched) ATF ligament. And I want the scar tissue to form to replace the ATF ligament. but a 6 weeks I want to organize that scar tissue to be optimal for function.

So the casting is initially used to intentionally create scar tissue. Remember, not all scar tissue is bad tissue. In this case we're using it to recreate a structure that has been damaged.

Jeff

Thanks. Does this mean that walking early breaks down that scar tissue, even in a cast?

Let's just say that if you're going to invest the time, effort and money into a project like a Brostrom, you certainly want to optimize your outcome.

In my patients, I'd rather they stick to the treatment plan of not walking. Some docs will walk their patients earlier than six weeks, but not in my office.

Jeff