Advancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuries

Abstract 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...

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Main Authors: Kun Liu, Xiaoyan Ji, Peng Su
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Surgery
Subjects:
Online Access:https://doi.org/10.1186/s12893-025-02779-y
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author Kun Liu
Xiaoyan Ji
Peng Su
author_facet Kun Liu
Xiaoyan Ji
Peng Su
author_sort Kun Liu
collection DOAJ
description Abstract 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.
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spelling doaj-art-4f2a1362b3d54c089f44a3a1b030a4d72025-02-02T12:06:24ZengBMCBMC Surgery1471-24822025-01-0125111010.1186/s12893-025-02779-yAdvancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuriesKun Liu0Xiaoyan Ji1Peng Su2Department of Gynaecology, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Hand and Foot Surgery, Shandong Provincial Hospital, Shandong First Medical UniversityDepartment of Hand and Foot Surgery, Shandong Provincial Hospital, Shandong First Medical UniversityAbstract 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.https://doi.org/10.1186/s12893-025-02779-yAnkle fracturesDeltoid ligamentDistal tibiofibular syndesmosis injuriesLigament repairMinimally invasive surgery
spellingShingle Kun Liu
Xiaoyan Ji
Peng Su
Advancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuries
BMC Surgery
Ankle fractures
Deltoid ligament
Distal tibiofibular syndesmosis injuries
Ligament repair
Minimally invasive surgery
title Advancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuries
title_full Advancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuries
title_fullStr Advancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuries
title_full_unstemmed Advancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuries
title_short Advancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuries
title_sort advancements in minimally invasive treatment of deltoid ligament injuries combined with distal tibiofibular syndesmosis injuries
topic Ankle fractures
Deltoid ligament
Distal tibiofibular syndesmosis injuries
Ligament repair
Minimally invasive surgery
url https://doi.org/10.1186/s12893-025-02779-y
work_keys_str_mv AT kunliu advancementsinminimallyinvasivetreatmentofdeltoidligamentinjuriescombinedwithdistaltibiofibularsyndesmosisinjuries
AT xiaoyanji advancementsinminimallyinvasivetreatmentofdeltoidligamentinjuriescombinedwithdistaltibiofibularsyndesmosisinjuries
AT pengsu advancementsinminimallyinvasivetreatmentofdeltoidligamentinjuriescombinedwithdistaltibiofibularsyndesmosisinjuries