Tarsal Collateral Ligament Reconstruction | Procedures

Procedure

Tarsal Collateral Ligament Reconstruction

Procedure Introduction

1. Make an incision on the medial side of the ankle joint and inspect the joint structure. Identify the origin of the long-axis portion of the medial collateral ligament (MCL) at the medial malleolus of the tibia.

2. Use the tibial insertion point of the MCL long-axis as a reference and place a K-wire aiming device obliquely upward, towards the head, to insert a K-wire. Make a small incision at the exit point of the K-wire.

3. Use a 2.0 mm cannulated drill to create a tibial tunnel.

4. As a surgical landmark, insert a syringe needle into the joint space to palpate and locate the central talus on the medial side.

5. Use a 2.0 mm cannulated drill to establish a distal talus tunnel.

6. Position the K-wire aiming device at the insertion of the MCL short portion on the proximal talus, and insert the K-wire in a distal and plantar direction. The exit point of the K-wire should be 3-5 mm lateral to the calcaneal tunnel.

7. Use a 2.0 mm cannulated drill to create a proximal talus tunnel.

8. Remove the 4-hole circular button from the ETButton.

9. Using a passing device, pass the remaining blue-and-white striped suture through the proximal talus tunnel from the outside to the inside.

10. Insert the passing device into the tibial tunnel, pass all sutures through the device, and pull the suture from the inside to the outside of the bone tunnel.

11. Pass the four sutures back through the 4-hole ETButton titanium plate.

12. Reduce the talocalcaneal joint to its anatomical position. Place the limb in a normal standing angle and maintain it.

13. Maintain the talocalcaneal joint in a slightly flexed position (approximately 80°). Tighten and secure the blue-and-white striped proximal tunnel sutures, and cut off the excess sutures.

Video demonstration