Abstract:

BACKGROUND: There are many methods to reconstruct the ankle with deltoid ligament injury, but there is no study to compare these methods.
OBJECTIVE: To compare the effect of Wiltberger, Deland, Kitaoka and Hintermann on the repair of ankle with deltoid ligament injury by three-dimensional finite element analysis.
METHODS: A three-dimensional finite element model of the ankle included six bony structures, cartilage and principal ligaments. In addition to the intact model, superficial deltoid-deficient, Wiltberger reconstruction, Deland reconstruction, Kitaoka reconstruction and Hintermann reconstruction models were simulated. Then, the biomechanics of the ankle joint was evaluated by loading the eversional or external torque through the range of ankle flexion.
RESULTS AND CONCLUSION: No reconstruction method could completely restore the values for ankle flexibility and the stresses of the lateral ligaments to normality. The Kitaoka procedure was the most effective technique in eliminating external rotation displacement. The Deland procedure was the most effective technique in restoring the alar tilt stability. Among the four deltoid ligament reconstruction techniques, Kitaoka and Deland procedures have the advantage in restoring the stability of ankle rotation.