Suture anchor repair for ruptured deltoid ligament in pronation ankle fractures

Abstract

Background: The deltoid ligament is the main medial stabilizer of the ankle joint. Rupture of this ligament is not uncommon in pronation ankle injuries and should be suspected in the absence of medial malleolar fractures. The purpose of this study was to evaluate the effectiveness of deltoid ligament reconstruction using suture anchor fixation to the medial malleolus for such conditions. Methods: Twenty-seven ankles with pronation ankle injuries were surgically treated and enrolled in this prospective study. Sixteen patients with pronation-external rotation injury (group 1) and 11 patients with pronation-abduction injury (group 2) were evaluated using the Foot and Ankle Outcome score (FAOS) and Ankle-Hindfoot scale. A composite questionnaire, including the Health-related Quality of Life Index (EQ-5D) and visual analog scales (VAS) for pain and satisfaction, was used to assess the surgical result. Results: All patients returned to their preinjury activity level at their final follow-up. The mean FAOS score for all patients included in the study was 94.44, and the mean Ankle-Hindfoot scale was 93.3, with no statistical difference between the two groups. Adequate range of motion was achieved in all patients. Twenty-five patients reported being fully satisfied, while two patients reported to be just satisfied, with an overall satisfaction scale of 8.85. Conclusions: Surgical reconstruction of a ruptured deltoid ligament in pronation ankle injury using suture anchors is an effective treatment modality with excellent functional outcome.