Arthroscopic Repair of Acute Rupture of the Deltoid Ligament

Abstract

Category: Ankle, Arthroscopy, Trauma Introduction/Purpose: An ankle dislocation represents a high-energy traumatic injury that often occurs in traffic accidents or during jumping sports and usually it is associated with bi or trimalleolar fractures. Rupture of the deltoid ligament can occur alone or combined. There is currently extensive literature advocating LCL repair (assisted) by arthroscopy. However, the ruptures of the deltoid ligament are repaired by open technique: direct suture in acute cases and ligamentoplasty involving the Spring ligament in chronic cases. The possibility of repairing by arthroscopy allows an improvement in morbidity and complication rate. Undiagnosed and improperly treated medial collateral ligament (MCL) injuries can lead to disabling conditions. Methods: This study presents three cases of fracture-dislocation of the ankle with rupture of both collateral ligaments. Results: In addition to the usual osteosynthesis, it was also performed a ligament repair of the LCL with the arthroscopic Brostrom procedure. In the presence of medial instability, suture anchors were used to repairing the deltoid ligament and inferior extensor retinaculum via an arthroscopic technique. All patients presented a good functional recovery, two of them with AOFAS above of 83 at the end of the 6-month follow-up and with a complete return to daily living activities. Conclusion: Apart from having studied only three cases, the prospect of injury repaired by minimally invasive surgery in the acute phase seems advantageous in selected patients, avoiding evolution to a disabling chronic situation.