We present a new method for reconstruction of chronic neglected tears of the deltoid ligament of the ankle joint, using half of the posterior tibialis tendon. This has been applied to 5 patients with an average follow-up of 6 years with very encouraging results. Five patients with a mean age of 28.2 years (range 23-50 years) visited us with chronic medial collateral ligament rupture. All were treated surgically where the deltoid ligament was reconstructed with half of the posterior tibialis tendon. Median time since injury was nine months (range 3-17 months), cause of rupture was sports injury and the preoperative AOFAS score 50,4 (range 48–64). All patients were followed up postoperatively for a mean of 3 years (range 1-5 years) and had a stable ankle with mean plantar flexion of 50° and dorsal flexion 20º. No complications occurred. The postoperative AOFAS score was 91,8 (range 85–97). Deltoid ligament reconstruction using half of the posterior tibialis tendon is an effective method of treatment for chronic neglected tears of the deltoid ligament. This treatment option has very good results, it closely mimics the anatomy of the deltoid ligament, the graft is strong, it is economical without the use of allografts and artificial grafts.
| Published in | Journal of Surgery (Volume 11, Issue 5) |
| DOI | 10.11648/j.js.20231105.16 |
| Page(s) | 119-123 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2023. Published by Science Publishing Group |
Ankle Sprains, Deltoid Ligament (DL), Autograft, Posterior Tibialis Tendon (PTT)
| [1] | J. Harris et al. Effects of isolated Weber B fibular fractures on the tibiotalar contact areaJ Foot Ankle Surg (2004). |
| [2] | J. M. Schuberth et al. Deltoid ligament integrity in lateral malleolar fractures: a comparative analysis of arthroscopic and radiographic assessmentsJ Foot Ankle Surg (2004). |
| [3] | Stephens MM, Sammarco GJ. The stabilizing role of the lateral complex around the ankle and subtalar joints. Foot Ankle 1992; 13: 130–6. |
| [4] | Baker JM, Ouzounian TJ. Complex ankle instability. Foot Ankle Clin 2000; 5: 887–96. |
| [5] | K. Watanabe et al. K. Watanabe et al. The role of ankle ligaments and articular geometry in stabilizing the ankle. |
| [6] | Y. Tourne et al. Y. Tourne et al. Surgical treatment of bi-and trimalleolar ankle fractures: should the medial collateral ligament be sutured or not? |
| [7] | G-r. Yu et al. Repair of the acute deltoid ligament complex rupture associated with ankle fractures: a multicenter clinical studyJ FootAnkle Surg (2015). |
| [8] | P. Kannus et al. Increasing number and incidence of low-trauma ankle fractures in elderly people: Finnish statistics during 1970–2000 and projections for the future. |
| [9] | Significant variations in surgical construct and return to sport protocols with syndesmotic injuries: an ISAKOS global perspective 2022, Journal of ISAKOS. |
| [10] | P. Golano et al. (2010) Anatomy of the ankle ligaments: a pictorial essay. Knee Surg Sports Traumatol Arthrosc. 18: 557–569. DOI 10.1007/s00167-010-1100-x. |
| [11] | B. Hintermann et al. Medial ankle instabilityAm J Sports Med (2004). |
| [12] | S. J. Sclafani Ligamentous injury of the lower tibiofibular syndesmosis: radiographic evidenceRadiology (1985). |
| [13] | K. J. Campbell et al. The ligament anatomy of the deltoid complex of the ankle: a qualitative and quantitative anatomical studyJ Bone Joint Surg Am (2014). |
| [14] | Peyre M, Rodineau J. L’auto varus: une technique d’exploration des instabilités externes de cheville. 3e Journées d’imagerie ostéo-articulaire de la Pitié Salpêtrière; Paris; 1993. |
| [15] | Bauer M, Bergstro¨m B, Hemborg A, Sandega˚rd J (1985) Malleolar fractures: nonoperative versus operative treatment. A controlled study. Clin Orthop Relat Res 199: 17–27. |
| [16] | Deltoid ligament injuries: diagnosis and management Foot Ankle Clin. 2006 Sep; 11 (3): 625-37. doi: 10.1016/j.fcl.2006.08.001. Beat Hintermann 1, Markus Knupp, Geert I Pagenstert. |
| [17] | Court-Brown CM, McBirnie J, Wilson G (1998) Adult ankle fractures—an increasing problem? Acta Orthop Scand 69 (1): 43–47. |
| [18] | Burwell HN, Charnley AD (1965) The Treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement. J Bone Jt Surg Br 47-B: 634–660. |
| [19] | Kristensen KD, Hansen T (1985) Closed treatment of ankle fractures. Stage II supination-eversion fractures followed for 20 years. Acta Orthop Scand 56 (2): 107–109. |
| [20] | Pankovich AM, Shivaram MS (1979) Anatomical basis of variability in injuries of the medial malleolus and the deltoid ligament. I. Anatomical studies. Acta Orthop Scand 50: 217–223. |
APA Style
Ioannis Erginousakis, Vasileios Mitronatsios, Christos Stragalis, John Aifantis, Dimitrios Erginousakis. (2023). Isolated Chronic Deltoid Ligament Tear Reconstructed Surgically with Half of the Tibialis Posterior Tendon. Journal of Surgery, 11(5), 119-123. https://doi.org/10.11648/j.js.20231105.16
ACS Style
Ioannis Erginousakis; Vasileios Mitronatsios; Christos Stragalis; John Aifantis; Dimitrios Erginousakis. Isolated Chronic Deltoid Ligament Tear Reconstructed Surgically with Half of the Tibialis Posterior Tendon. J. Surg. 2023, 11(5), 119-123. doi: 10.11648/j.js.20231105.16
AMA Style
Ioannis Erginousakis, Vasileios Mitronatsios, Christos Stragalis, John Aifantis, Dimitrios Erginousakis. Isolated Chronic Deltoid Ligament Tear Reconstructed Surgically with Half of the Tibialis Posterior Tendon. J Surg. 2023;11(5):119-123. doi: 10.11648/j.js.20231105.16
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.js.20231105.16,
author = {Ioannis Erginousakis and Vasileios Mitronatsios and Christos Stragalis and John Aifantis and Dimitrios Erginousakis},
title = {Isolated Chronic Deltoid Ligament Tear Reconstructed Surgically with Half of the Tibialis Posterior Tendon},
journal = {Journal of Surgery},
volume = {11},
number = {5},
pages = {119-123},
doi = {10.11648/j.js.20231105.16},
url = {https://doi.org/10.11648/j.js.20231105.16},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20231105.16},
abstract = {We present a new method for reconstruction of chronic neglected tears of the deltoid ligament of the ankle joint, using half of the posterior tibialis tendon. This has been applied to 5 patients with an average follow-up of 6 years with very encouraging results. Five patients with a mean age of 28.2 years (range 23-50 years) visited us with chronic medial collateral ligament rupture. All were treated surgically where the deltoid ligament was reconstructed with half of the posterior tibialis tendon. Median time since injury was nine months (range 3-17 months), cause of rupture was sports injury and the preoperative AOFAS score 50,4 (range 48–64). All patients were followed up postoperatively for a mean of 3 years (range 1-5 years) and had a stable ankle with mean plantar flexion of 50° and dorsal flexion 20º. No complications occurred. The postoperative AOFAS score was 91,8 (range 85–97). Deltoid ligament reconstruction using half of the posterior tibialis tendon is an effective method of treatment for chronic neglected tears of the deltoid ligament. This treatment option has very good results, it closely mimics the anatomy of the deltoid ligament, the graft is strong, it is economical without the use of allografts and artificial grafts.
},
year = {2023}
}
TY - JOUR T1 - Isolated Chronic Deltoid Ligament Tear Reconstructed Surgically with Half of the Tibialis Posterior Tendon AU - Ioannis Erginousakis AU - Vasileios Mitronatsios AU - Christos Stragalis AU - John Aifantis AU - Dimitrios Erginousakis Y1 - 2023/10/31 PY - 2023 N1 - https://doi.org/10.11648/j.js.20231105.16 DO - 10.11648/j.js.20231105.16 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 119 EP - 123 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20231105.16 AB - We present a new method for reconstruction of chronic neglected tears of the deltoid ligament of the ankle joint, using half of the posterior tibialis tendon. This has been applied to 5 patients with an average follow-up of 6 years with very encouraging results. Five patients with a mean age of 28.2 years (range 23-50 years) visited us with chronic medial collateral ligament rupture. All were treated surgically where the deltoid ligament was reconstructed with half of the posterior tibialis tendon. Median time since injury was nine months (range 3-17 months), cause of rupture was sports injury and the preoperative AOFAS score 50,4 (range 48–64). All patients were followed up postoperatively for a mean of 3 years (range 1-5 years) and had a stable ankle with mean plantar flexion of 50° and dorsal flexion 20º. No complications occurred. The postoperative AOFAS score was 91,8 (range 85–97). Deltoid ligament reconstruction using half of the posterior tibialis tendon is an effective method of treatment for chronic neglected tears of the deltoid ligament. This treatment option has very good results, it closely mimics the anatomy of the deltoid ligament, the graft is strong, it is economical without the use of allografts and artificial grafts. VL - 11 IS - 5 ER -
Information
Email: