Chronic medial ankle instability medial drive through sign and surgical repair technique

Abstract

It has been estimated that the deltoid ligament complex is injured in 5-15% of acute inversion ankle injuries. This injury can result in clinically significant pain and instability. Accurate diagnosis is a combination of positive clinical findings and advanced imaging. However, arthroscopy can be a valuable tool in the diagnosis of deltoid ligament (medial ankle) instability. The authors describe the medial drive-through sign, an arthroscopic finding indicative of clinically significant deltoid ligament instability in which the ability to pass a 4mm shaver between the medial malleolus and talus is indicative of a positive medial drive through sign. The authors further introduce an anchor assisted surgical repair technique for direct repair of the deltoid ligament complex that is currently being studied for later reporting and publication.