Reconstruction of Deltoid Ligament Using Low Invasive Surgical Technique at Treatment of Ankle Joint Fractures

Comparative analysis of treatment results of 68 patients with malleolus fractures and injury of deltoid ligament was performed. Depending on the treatment technique all patients were subdivided into four groups. Main group - surgical treatment of fractures and reconstruction of deltoid ligament with Twinflix screw (n=30), comparative groups - surgical treatment of fractures with transcutaneous suturing of deltoid ligament (n=10) and ligament plasty with Р -shaped sutures (n=8); control group - conservative treatment of fractures and deltoid ligament injury (n=20). Follow-up time made up 6 months - 2 years. Evaluation of treatment results was performed by adopted scale of American Orthopaedic Foot and Ankle Society. Patients were examined using clinical and roentgenologic methods as well as ultrasound and rheovasography. In the main group excellent result was achieved in 23.1%, good result - in 65.3%, satisfactory - in 11.6% of patients. In control group they made up 16.8%, 61.2% and 19.5%, respectively, with poor result in 2.5% of patients. It was demonstrated that application of low invasive osteosynthesis in combination with reconstruction of deltoid ligament using Twinfix screw reduced considerably the probability of posttraumatic arthrosis development as well as provided for complete restoration of the ligament with preservation of its elastic properties and joint stability.