Four-bundle anatomic deltoid ligament reconstruction: Surgical technique

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-09-04 DOI:10.1002/jeo2.70279

Bruno Olory, Piero Agostinone, Ashraf T. Hantouly, Francesca Zannoni, Khalid Al-Khelaifi, Emmanouil Papakostas, Alan Getgood, Pieter D'Hooghe

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Abstract

The deltoid ligament, the strongest medial ankle ligament, is often overlooked in ankle injuries, despite its substantial role in ankle stability. Medial sprains, accounting for 3%–4% of ankle injuries, are frequently misdiagnosed, leading to chronic pain, instability, and hindfoot valgus deformity. While most cases respond to conservative treatment, chronic injuries that fail conservative measures require surgical intervention. This technical paper introduces a novel four-bundle deltoid ligament reconstruction technique, restoring two anterior (superficial and deep) and two posterior (superficial and deep) bundles. This approach provides a solution for severe injuries and high-demand patients, permitting functional stability.

Level of Evidence

Level V.

Abstract Image

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四束解剖三角韧带重建：外科技术

三角韧带是最坚固的踝关节内侧韧带，尽管它在踝关节稳定性中起着重要作用，但在踝关节损伤中却经常被忽视。内侧扭伤占踝关节损伤的3%-4%，经常被误诊，导致慢性疼痛、不稳定和后足外翻畸形。虽然大多数病例对保守治疗有反应，但慢性损伤的保守治疗失败需要手术干预。本文介绍了一种新的四束三角韧带重建技术，恢复了两个前束（浅束和深束）和两个后束（浅束和深束）。这种方法为严重损伤和高需求患者提供了解决方案，允许功能稳定。证据等级V级。

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