Anatomic deltoid ligament repair with anchor-to-post suture reinforcement technique tip

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1、ANATOMICDELTOIDUGAMENTREPAIRWITHANCHORTOPOSTSUTUREREINFORCEMENT:TECHNIQUETIPWilliamLack,MD',PhinitPhisiticul,MD^,JohnE.FeminoABSTRACTINTRODUCTIONThedeltoidligamentistheprimaryligamentousThedeltoidligamentistheprimaryligamentousstabilizeroftheanklejointBothsuperficialanddeepstabilizeroftheanklejoi

2、nt.Bothsuperficialanddeepcomponentsoftheligamentcanbedisruptedwithcomponentsoftheligamentcanbedisruptedwithaarotationalanklefracture,chronicankleinstability,rotationalanklefracture,chronicankleinstability,orinorinlatestageadultacquiredflatfootdeformity.Thelatestageadultacquiredfiatfootdeformity.^

3、'^Theroleofroleofdeltoidligamentrepairintheseconditionshasdeltoidligamentrepairintheseconditionshasbeenlim-beenlimitedanditscontributiontoarthritisislargefy^itedanditscontributiontoarthritisislargelyunknown.unknown.Neglectofthedeltoidligamentinthetreat-Neglectofthedeltoidligamentintiietreatmentof

4、anklementofankleinjuriesmaybeduetodifficultiesininjuriesmaybeduetodifficultiesindiagnosisandlackdiagnosisandlackofaneffectivemethodforrepair.ofaneffectivemethodforrepair.MostacuterepairtechniquesaddressthesuperficialOperativemanagementofdeltoidligamentinju-deltoidligamentwithdirectend-to-endrepai

5、r,fixa-riesmaybeindicatedacutelyinunstablebimalleolartionthroughbonetunnels,orsutureanchorrepairequivalentanklefractures,particularlywhenthemortiseofavulsioninjuries.Deepdeltoidligamentrepairremainswidemediallyafteranatomicfixationofthehasbeendescribedusingdirectend-to-endrepairlateralsideofthean

6、kle.Thishasbeenassociatedwithwithsutures,aswellasbyautograftandallograftentrapmentofthedeltoidwitiiinthemedialgutterofthetendonreconstructionutilizingvarioustechniques.ankle.''^'^'''äDelayedrepairmaybeindicatedformedialNewertenodesistechniqueshavebeendescribedanklemstabilitywithorwithouthindfootm

7、alalignment'^forlatereconstructionofbothdeepandsuperficialMostacuterepairtechniquesaddressthesuperficialcomponentsinpatientswithstage4adultacquireddeltoidligamentwithdirectend-to-endrepair,fixationflatfootdeformity.thr