Liu Kun, Ji Xiaoyan, Su Peng
Department of Gynaecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Department of Hand and Foot Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, China.
BMC Surg. 2025 Jan 29;25(1):50. doi: 10.1186/s12893-025-02779-y.
The deltoid ligament (medial collateral ligament) and the syndesmosis (a composite ligamentous structure at the distal tibiofibular junction) are critical for maintaining ankle stability. In cases of high-energy ankle fractures, these structures are often injured simultaneously, leading to instability and potential long-term complications such as post-traumatic arthritis. This review aims to explore advancements in minimally invasive techniques for the treatment of combined deltoid ligament and syndesmosis injuries, with a focus on optimizing surgical outcomes and reducing patient morbidity. Current treatment strategies primarily involve cortical screws for syndesmosis stabilization and anchor fixation for deltoid ligament repair. Recent innovations, such as bioabsorbable screws, suture-button devices with elastic micromotion, and syndesmotic plates, have demonstrated potential in improving biomechanical stability while minimizing complications. Furthermore, minimally invasive techniques, including arthroscopic repairs with suture anchors, as well as ligament reconstruction using autografts, allografts, or synthetic ligaments, are becoming increasingly popular. By incorporating these advancements, the field is moving toward more effective and patient-centered approaches to achieve anatomical and functional restoration under minimally invasive principles. Future research should focus on further validating these techniques and identifying the most effective strategies for complex injuries.
三角韧带（内侧副韧带）和下胫腓联合（胫腓骨远端关节处的复合韧带结构）对于维持踝关节稳定性至关重要。在高能踝关节骨折的情况下，这些结构常同时受损，导致踝关节不稳定以及创伤后关节炎等潜在的长期并发症。本综述旨在探讨治疗三角韧带和下胫腓联合联合损伤的微创技术进展，重点是优化手术效果并降低患者发病率。目前的治疗策略主要包括使用皮质螺钉固定下胫腓联合以及使用锚钉修复三角韧带。近期的创新技术，如生物可吸收螺钉、具有弹性微动的缝线纽扣装置和下胫腓联合钢板，已显示出在提高生物力学稳定性同时减少并发症方面的潜力。此外，微创技术，包括使用缝线锚钉的关节镜修复以及使用自体移植物、异体移植物或合成韧带进行韧带重建，正变得越来越普遍。通过纳入这些进展，该领域正朝着更有效且以患者为中心的方法发展，以在微创原则下实现解剖和功能恢复。未来的研究应专注于进一步验证这些技术，并确定针对复杂损伤的最有效策略。
