title: A radiographic investigation to determine the safety of suture anchor systems for pediatric modified Broström ankle ligament reconstruction.
abstract: BACKGROUND
  The modified Broström ligament reconstruction using anchor sutures has been performed in adults with clinical success; however, the safety parameters for the use of suture anchors in adolescent lateral ankle ligament reconstruction have not been established.
  
  
  OBJECTIVE
  To perform a radiographic analysis comparing the depth of penetration of suture anchors in adult ankle ligament reconstruction with the average distance of the physis from the tip of the fibula in adolescents.
  
  
  METHODS
  Cross-sectional study, Level of evidence, 4.
  
  
  METHODS
  Forty postoperative ankle radiographs of adult patients who had a modified Broström procedure were compared with 40 normal adolescent ankle radiographs. In the adult group, the distance of the suture anchor penetration from the distal tip of the fibula was measured; in the adolescent group, the distance of the physis from the distal tip of the fibula was measured.
  
  
  RESULTS
  The mean depth of the suture anchors was 17 mm (range, 14-21 mm) from the tip of the fibula in the adult group, and the mean distance of the growth plate was 23 mm (range, 18-29 mm) in the adolescent group. Eight radiographs from the adolescent group (20%) had a physis measurement of <22 mm on the anteroposterior or mortise view.
  
  
  CONCLUSIONS
  Using careful preoperative planning and intraoperative technique, it is possible to safely perform lateral ankle ligament repair in the skeletally immature patient using suture anchors.
authors.affiliation: St. Vincent's Hospital, Sydney, Australia.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Hazratwala
authors.forename: Alistair
authors.initials: A
authors.lastname: Best
authors.forename: Matthew
authors.initials: M
authors.lastname: Kopplin
authors.forename: Eric
authors.initials: E
authors.lastname: Giza
authors.forename: Martin
authors.initials: M
authors.lastname: Sullivan
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016512:Ankle Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007593:Joint Instability; D017844:Lateral Ligament, Ankle / Q000293:injuries* / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome