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四束解剖型三角韧带重建:手术技术

Four-bundle anatomic deltoid ligament reconstruction: Surgical technique.

作者信息

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

机构信息

Aspetar Orthopaedic and Sports Medicine Hospital Doha Qatar.

出版信息

J Exp Orthop. 2025 Sep 4;12(3):e70279. doi: 10.1002/jeo2.70279. eCollection 2025 Jul.

DOI:10.1002/jeo2.70279
PMID:40919489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12409835/
Abstract

UNLABELLED

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.

摘要

未标注

三角韧带是踝关节最强的内侧韧带,尽管其在踝关节稳定性中起重要作用,但在踝关节损伤中常被忽视。内侧扭伤占踝关节损伤的3%-4%,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效,但保守治疗无效的慢性损伤需要手术干预。本文介绍一种新颖的四束三角韧带重建技术,恢复两条前束(浅层和深层)和两条后束(浅层和深层)。该方法为严重损伤和高要求患者提供了解决方案,可实现功能稳定。

证据级别

V级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c5e/12409835/60e9d0443232/JEO2-12-e70279-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c5e/12409835/10f7fd6b9582/JEO2-12-e70279-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c5e/12409835/60e9d0443232/JEO2-12-e70279-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c5e/12409835/10f7fd6b9582/JEO2-12-e70279-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c5e/12409835/60e9d0443232/JEO2-12-e70279-g007.jpg

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本文引用的文献

1
Deltoid ligament injuries: A review of the anatomy, diagnosis and treatments.三角韧带损伤:解剖、诊断和治疗的综述。
Knee Surg Sports Traumatol Arthrosc. 2024 Dec;32(12):3052-3064. doi: 10.1002/ksa.12274. Epub 2024 May 26.
2
Modified Gracilis Autograft Preparation for Arthroscopic Anterior Talofibular and Calcaneofibular Ligament Anatomic Reconstruction: Technical Tip.关节镜下距腓前韧带和跟腓韧带解剖重建的改良股薄肌自体移植物制备:技术要点
Foot Ankle Orthop. 2024 May 16;9(2):24730114241242780. doi: 10.1177/24730114241242780. eCollection 2024 Apr.
3
The deltoid ligament is constantly formed by four fascicles reaching the navicular, spring ligament complex, calcaneus and talus.
三角韧带由四个纤维束组成,分别到达舟骨、弹簧韧带复合体、跟骨和距骨。
Knee Surg Sports Traumatol Arthrosc. 2024 Dec;32(12):3065-3075. doi: 10.1002/ksa.12173. Epub 2024 May 17.
4
Combined Deltoid and Spring Ligament Reconstruction Using the Quadrangular Construct: Our Experience and Review of the Literature.使用四边形结构进行三角肌和弹簧韧带联合重建:我们的经验及文献综述
Cureus. 2023 Dec 11;15(12):e50361. doi: 10.7759/cureus.50361. eCollection 2023 Dec.
5
Incidence of Medial Deltoid Ligament Instability in 226 Patients With Chronic Ankle Instability.226 例慢性踝关节不稳定患者中肩袖中盂肱韧带不稳定的发生率。
J Foot Ankle Surg. 2024 Mar-Apr;63(2):245-249. doi: 10.1053/j.jfas.2023.11.011. Epub 2023 Dec 1.
6
Arthroscopic Deltoid Ligament Reconstruction in Rotational Ankle Instability.关节镜下三角韧带重建治疗旋转性踝关节不稳
Arthrosc Tech. 2023 Jun 19;12(7):e1179-e1184. doi: 10.1016/j.eats.2023.03.007. eCollection 2023 Jul.
7
Sprain of the Medial Ankle Ligament Complex.内侧踝关节韧带复合体扭伤。
Foot Ankle Clin. 2023 Jun;28(2):355-367. doi: 10.1016/j.fcl.2023.01.009. Epub 2023 Mar 27.
8
Repair of the Deltoid Ligament Using Posterior Tibial Tendon Autograft:A Novel Technique.使用自体胫后肌腱修复三角韧带:一种新技术
J Foot Ankle Surg. 2019 Jan;58(1):165-170. doi: 10.1053/j.jfas.2018.07.002.
9
Medial-sided Ankle Pain: Deltoid Ligament and Beyond.踝关节内侧疼痛:三角韧带及其他相关问题
Magn Reson Imaging Clin N Am. 2017 Feb;25(1):63-77. doi: 10.1016/j.mric.2016.08.003. Epub 2016 Oct 20.
10
Osteoligamentous injuries of the medial ankle joint.踝关节内侧的骨韧带损伤。
Eur J Trauma Emerg Surg. 2015 Dec;41(6):615-21. doi: 10.1007/s00068-015-0548-2. Epub 2015 Jul 4.