title: Treatment of chronic deltoid ligament injury using suture anchors.
abstract: OBJECTIVE
  To explore the efficacy of overlapping suture-anchor fixation for treatment of chronic deltoid ligament injury.
  
  
  METHODS
  Seventeen patients (11 men, 6 women of mean age 32.1 years [range, 18-58 years]) who had undergone surgery for chronic deltoid ligament injury from January 2007 to December 2011 were retrospectively analyzed. Preoperatively, they had undergone bilateral weight-bearing posterior-anterior radiographs, (MRI) and ultrasound examinations of the ankle. Ankle arthroscopy was performed to confirm the diagnosis, followed by surgery to clear intra-articular proliferating synovial tissues and remove cartilage debris and scar tissue. The deep layer of the deltoid ligament was sutured onto the tip of the medial malleolus and its superficial layer sutured onto its periosteum and fixed with suture anchors. American Orthopedic Foot and Ankle Society (AOFAS) scoring system for the ankle-hindfoot was used to evaluate the ankles pre- and post-operatively.
  
  
  RESULTS
  The 17 patients were followed up for 12-34 months (mean 20.1 months). The angle between the long axes of the talus and first metatarsal and the hindfoot angle measured in a hindfoot alignment view (as described by Saltzman) were reduced from 5.4° ± 1.8° and 8.2° ± 2.6° preoperatively to 4.0° ± 0.9° and 5.3° ± 1.3° postoperatively, respectively. The mean AOFAS ankle-hindfoot score was 76.8 ± 7.0 preoperatively and 94.1 ± 3.3 at the last follow-up visit. Ten patients were scored as excellent, six as good, and one as fair. Pain was relieved in all patients and no patients had recurrent deltoid ligament injury.
  
  
  CONCLUSIONS
  Using suture anchors to treat chronic deltoid ligament injury has relatively satisfactory outcomes.
authors.affiliation: Department of Orthopaedics, Huashan Hospital, University of Fudan, Shanghai, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.forename: Jia-zhang
authors.initials: JZ
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001182:Arthroscopy; D002908:Chronic Disease; D005260:Female; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D053441:Suture Anchors; D013536:Suture Techniques; D055815:Young Adult
keywords: Ankle; Deltoid ligament; Suture anchor