Progress in minimally invasive treatment of deltoid ligament with inferior tibiofibular syndesmosis injury

doi:10.3877/cma.j.issn.1674-134X.2021.01.017

Abstract

Abstract:

The triangular ligament is also known as the medial collateral ligament of the ankle joint, and the inferior tibiofibular union is a compound ligament structure at the distal end of the tibiofibula. Both of them often happen at the same time due to violent fracture of ankle joint, and are often accompanied by serious complications. Surgery is often used to treat the combined injury of the deltoid ligament with inferior tibiofibular syndesmosis. Cortical screws are often used for the combined injury of inferior tibiofibular syndesmosis, and anchors are often used for the fracture of the deltoid ligament. With the development and update of foot and ankle surgery and sports medicine, new treatment schemes are gradually applied in clinical practice. For example, absorbable screws penetrating the bone cortex, elastic fretting materials (i.e. tibiofibular hook, tibiofibular plate and button device), autogenous, allogeneic or artificial ligament under limited incision, arthroscopic repair of the ligaments of the broken end of the suture clip. Therefore, in the future clinical diagnosis and treatment, the treatment of combined deltoid ligament with inferior tibiofibular syndesmosis will focus on the repair and reconstruction of ligament under the concept of minimally invasive.

Key words: Ankle fractures, Collateral ligaments, Minimally invasive sugical procedures

Jing Zhang, Bin Wang, Wen Qiao, Lingbao Kong, Yuanyuan Li, Xin Lyv. Progress in minimally invasive treatment of deltoid ligament with inferior tibiofibular syndesmosis injury[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(01): 104-110.

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https://zhgjwkzz.cma-cmc.com.cn/EN/Y2021/V15/I01/104

References 51

[1]	Clanton TO, Williams BT, Backus JD, et al. Biomechanical analysis of the individual ligament contributions to syndesmotic stability[J]. Foot Ankle Int, 2017, 38(1): 66-75.
[2]	Levy DM, Reid K, Gross CE. Ankle syndesmotic injuries: a systematic review[J]. Tech Orthop, 2017, 32(2): 80-83.
[3]	林浩，徐世明，黄永军，等．踝三角韧带修复重建的解剖与生物力学的基础研究[J]．中国临床解剖学杂志，2017，35(3)：318-321＋326.
[4]	黄辉，杨云峰．下胫腓联合损伤的诊断和治疗进展[J]．中国修复重建外科杂志，2020，34(10)：1346-1351.
[5]	Boyd RP, Nawaz SZ, Khaleel A. A new assessment for syndesmosis injury-the 'Chertsey test'[J]. Injury, 2016, 47(6): 1293-1296.
[6]	Ebraheim NA, Lu J, Yang H, et al. Radiographic and CT evaluation of tibiofibular syndesmotic diastasis: a cadaver study[J]. Foot Ankle Int, 1997, 18(11): 693-698.
[7]	张强，胡彬，彭亮，等．踝部三角韧带损伤的诊疗进展[J]．中国运动医学杂志，2017，36(6)：544-547＋551.
[8]	张庆祥，鲁胜武，陆锡平．慢性下胫腓联合损伤的临床观察[J]．世界最新医学信息文摘，2019，19(72)：71-73.
[9]	Alshalawi S, Galhoum AE, Alrashidi Y, et al. Medial ankle instability: the deltoid dilemma[J]. Foot Ankle Clin, 2018, 23(4): 639-657.
[10]	索海军，王娜，邱海滨，等．高频超声诊断踝关节外侧副韧带损伤的临床价值[J]．中国骨与关节损伤杂志，2020，35(4)：427-429.
[11]	Turky M, Menon KV, Saeed K. Arthroscopic grading of injuries of the inferior tibiofibular syndesmosis[J]. J Foot Ankle Surg, 2018, 57(6): 1125-1129.
[12]	李庭，公茂琪，孙旭，等．无外踝骨折的下胫腓分离的临床观察[J]．中国医刊，2016，51(10)：55-60.
[13]	洪意侠，贾兆锋．下胫腓联合损伤手术治疗进展[J]．国际骨科学杂志，2020，41(1)：16-18.
[14]	Bekerom MPJvd, Hogervorst M, Bolhuis HW, et al. Operative aspects of the syndesmotic screw: review of current concepts[J]. Injury, 2008, 39(4): 491-498.
[15]	Verim O, Er MS, Altinel L, et al. Biomechanical evaluation of syndesmotic screw position: a finite-element analysis[J]. J Orthop Trauma, 2014, 28(4): 210-215.
[16]	Yoshimura I, Naito M, Kanazawa K, et al. Arthroscopic findings in Maisonneuve fractures[J]. J Orthop Sci, 2008, 13(1): 3-6.
[17]	Stufkens SA, Van DM, Doornberg JN, et al. Evidence-based treatment of maisonneuve fractures[J]. J Foot Ankle Surg, 2011, 50(1): 62-67.
[18]	Liu Q, Zhao G, Yu B, et al. Effects of inferior tibiofibular syndesmosis injury and screw stabilization on motion of the ankle: a finite element study[J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(4): 1228-1235.
[19]	Song DJ, Lanzi JT, Groth AT, et al. The effect of syndesmosis screw removal on the reduction of the distal tibiofibular joint: a prospective radiographic study[J]. Foot Ankle Int, 2014, 35(6): 543-548.
[20]	Kelly M, Vasconcellos D, Osman WS, et al. Alterations in tibiotalar joint reaction force following syndesmotic injury are restored with static syndesmotic fixation[J]. Clin Biomech (Bristol, Avon), 2019, 69(9): 156-163.
[21]	温晓东，鹿军，赵宏谋，等．可吸收螺钉与金属螺钉治疗Maisonneuve骨折对比分析[J]．中国修复重建外科杂志，2020，34(04)：482-488.
[22]	Schon JM, Williams BT, Venderley MB, et al. A 3-D CT analysis of screw and suture-button fixation of the syndesmosis[J]. Foot Ankle Int, 2017, 38(2): 208-214.
[23]	Morellato J, Louati H, Bodrogi A, et al. The effect of varying tension of a suture button construct in fixation of the tibiofibular syndesmosis-evaluation using stress computed tomography[J]. J Orthop Trauma, 2017, 31(2): 103-110.
[24]	Anand A, Wei R, Patel A, et al. Tightrope fixation of syndesmotic injuries in Weber C ankle fractures: a multicentre case series[J]. Eur J Orthop Surg Traumatol, 2017, 27(4): 461-467.
[25]	Xu G, Chen W, Zhang Q, et al. Flexible fixation of syndesmotic diastasis using the assembled bolt-tightrope system[J]. Scand J Trauma Resusc Emerg Med, 2013, 21(1): 71-79.
[26]	孙正涛，孙海钰，陈斌，等．下胫腓联合损伤的诊治进展[J]．实用骨科杂志，2019，25(6)：537-541.
[27]	费骏，赖震，魏威，等．不同内固定方法对下胫腓联合损伤稳定性重建的生物力学研究[J]．中国骨伤，2015，28(12)：1147-1152.
[28]	Jy M, Qj L, Lin B, et al. Surgical treatment of ankle syndesmosis injuries with syndesmosis elastic hook[J]. Chin Med J (Engl), 2016, 129(22): 2749-2752.
[29]	Ræder BW, Figved W, Madsen JE, et al. Better outcome for suture button compared with single syndesmotic screw for syndesmosis injury: five-year results of a randomized controlled trial[J]. Bone Joint J, 2020, 102-B(2): 212-219.
[30]	叶永志，李家德，林斌，等．锁扣带袢钛板治疗伴有下胫腓联合损伤的踝关节骨折[J]．临床骨科杂志，2020，23(2)：174.
[31]	吴刚，谭伦，罗晓中，等．尼斯结与螺钉固定治疗下胫腓联合损伤的比较[J]．中国矫形外科杂志，2020，28(8)：682-687.
[32]	陈祥福，倪维玉，林丙剑，等．Endobutton钢板内固定治疗60例下胫腓联合损伤的临床研究分析[J]．浙江创伤外科，2017，22(3)：527-529.
[33]	Jia Z, Cheng J, Zhong H, et al. Titanium cable isotonic annular fixation system for the treatment of distal tibiofibular syndesmosis injury[J]. Am J Transl Res, 2019, 11(8): 4967-4975.
[34]	宣勇，骆宇春，张焱，等．循环载荷对腓骨长肌腱重建下胫腓联合损伤的生物力学性能分析[J]．中国矫形外科杂志，2015，23(10)：928-932.
[35]	沈影超，王强．聚对苯二甲酸乙二酯人工韧带重建治疗下胫腓联合体损伤中期疗效分析[J]．创伤外科杂志，2016，18(7)：403-407.
[36]	Connors JC, Grossman JP, Zulauf EE, et al. Syndesmotic ligament allograft reconstruction for treatment of chronic diastasis[J]. J Foot Ankle Surg, 2020, 59(4): 835-840.
[37]	Li HY, Zhou RS, Wu ZY, et al. Strength of suture-button fixation versus ligament reconstruction in syndesmotic injury: a biomechanical study[J]. Int Orthop, 2019, 43(3): 705-711.
[38]	Woo SH, Bae SY, Chung HJ. Short-term results of a ruptured deltoid ligament repair during an acute ankle fracture fixation[J]. Foot Ankle Int, 2018, 39(1): 35-45.
[39]	俞光荣，洪浩．踝关节损伤的治疗进展与思考[J]．中国骨伤，2016，29(12)：1071-1073.
[40]	Wang X, Zhang C, Yin JW, et al. Treatment of medial malleolus or pure deltoid ligament injury in patients with supination-external rotation type IV ankle fractures[J]. Orthop Surg, 2017, 9(1): 42-48.
[41]	叶永志，胡妙仙，叶颂华．可吸收锚钉修复三角韧带损伤在踝关节骨折术中的应用[J]．中国骨与关节损伤杂志，2020，35(6)：641-642.
[42]	Shen JJ, Gao YB, Huang JF, et al. Suture anchors for primary deltoid ligament repair associated with acute ankle fractures[J]. Acta Orthop Belg, 2019, 85(3): 387-391.
[43]	吴健波，朱敏华，余小冬．切开复位内固定联合韧带修复术治疗踝关节骨折合并三角韧带损伤的疗效及对骨代谢的影响[J]．创伤外科杂志，2020，22(6)：465-469.
[44]	包毅敏．带线锚钉内固定治疗踝关节骨折合并三角韧带损伤临床研究[J]．实用骨科杂志，2017，23(4)：371-374.
[45]	Yoo JH, Lee WC, Moon JS. Simultaneous reconstruction of the medial and lateral ligament complexes of the ankle joint with semitendinosus tendon allograft. A case report[J]. J Bone Joint Surg Am, 2009, 91(6): 1491-1496.
[46]	Persaud S, Catanzariti AR. Repair of the deltoid ligament using posterior tibial tendon autograft: a novel technique[J]. J Foot Ankle Surg, 2019, 58(1): 165-170.
[47]	Brodell JJ, Macdonald A, Perkins JA, et al. Deltoid-spring ligament reconstruction in adult acquired flatfoot deformity with medial peritalar instability[J]. Foot Ankle Int, 2019, 40(7): 753-761.
[48]	Oburu E, Myerson MS. Deltoid ligament repair in flatfoot deformity [J]. Foot Ankle Clin, 2017, 22(3): 503-514.
[49]	Vega J, Allmendinger J, Malagelada F, et al. Combined arthroscopic all-inside repair of lateral and medial ankle ligaments is an effective treatment for rotational ankle instability [J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(1): 132-140.
[50]	Kusnezov NA, Eisenstein ED, Diab N, et al. Medial malleolar fractures and associated deltoid ligament disruptions: current management controversies[J]. Orthopedics, 2017, 40(2): e216-e222.
[51]	Acevedo J, Kreulen C, Cedeno AA, et al. Technique for arthroscopic deltoid ligament repair with description of safe zones[J]. Foot Ankle Int, 2020, 41(5): 605-611.

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