The Naperville Sun

Tuesday, December 23, 2008

A new 'Lim' | Ankle surgeon gives another option for healing sprains

By Katie Foutz
kfoutz@scn1.com

Spraining an ankle is easy to do - it's one of the most common injuries in the nation, affection 1 million Americans each year.

Recovering from a sprained ankle is more complicated. The ligaments and tendons connection the leg and foot bones get stretched and scarred and don't just snap back into their old positions like rubber bands, said Naperville foot and ankle surgeon Robert Lim.

That can result in pain and instability that can bench an elite athlete - or keep a father from playing with his kids in the yard. As a dad and former Division III college soccer player himself, Lim understood. He thought of a way to perform reconstructive surgery that quickly returns the ankle to pre-injury status.

"For high-level athletes - high school athletes going for scholarships and college athletes going for the pros - it's very important not to miss being scouted," Lim said.

Older procedures sew the original tendon back together with nylon, or transplant tendons donated from other parts of the patient's body or from a tissue bank. They can help someone get back to walking and other everyday activities but can't always get them back to a sport. They also require at least four months of recovery time.

Unofficially dubbed the Lim procedure, the new surgery replaces the damaged ligament with nylon fiber anchored to the bone with meal screws. The new ligament is stronger, tighter and more durable than the old one and allows patients to get back into athletic training in one to two months, Lim said.

In 10 years of performing the procedure, he's never seen one nylon ligament break.

He created the procedure in response to one of his patients. He was a semiprofessional football player who had a chance to fulfill a dream: to try out for the Chicago Bears. Several orthopedic doctors had told him that to fix his chronic ankle-rolling issues, he would need reconstructive surgery but would be on the injured list for four to six months and possibly never run again.

Soon after he met the football player, Lim learned about a soft-tissue anchor he'd never seen before and consulted his surgical colleagues on whether it could work on ankle reconstruction. Theoretically, it could, they said.

Lim told the football player about his options, and he was all for it. The experiment worked.

"He didn't make the team, but he was happy he could try out, and he kept playing semipro ball," Lim said.

Rich Monis, assistant athletic trainer and teacher at Neuqua Valley High School, has worked with Lim on staff for the Chicago Fire soccer team. He said Lim's ankle surgery patients have seen good results, whether they're athletes or weekend warriors.

"You see a lot of people now, more people involved in athletics and recreational sports," Monis said. "And most sports out there require a lot of change in direction and cutting, and with that type of movement, you risk rolling your ankle or planting your foot and risk your ankle rolling with it. It's exciting there's another option to look at and to investigate when someone has a chronic ankle problem they just can't seem to get over."

Not everyone with a mild or moderate ankle injury needs surgery, Lim said. He also would not operate on a young teenager whose bones are still growing. (His youngest patient was 15.) But for severe injuries restricting everyday life, the Lim procedure is another option.

"It affects your lifestyle," he said. "A lot of people take it for granted and just live with it. A lot of doctors don't take the time to treat it properly."