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Objective To compare the outcomes of surgical treatment of ankle fracture with or without repair of deltoid ligament(DL) rupture.Methods Between March 2009 and December 2015,75 patients were treated surgically at Department of Foot and Ankle Surgery,Honghui Hospital for ankle fracture with DL rupture.Of them,the DL rupture was repaired in 20(repair group) and not in 54(non-repair group).The 2 groups were compared in terms of pre- and post-operative medial clear space(MCS),rate of radiological MCS malreduction(MCS>5mm),rate of surgical failure,the American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score and visual analogue scale(VAS).The outcomes of AO/OTA types B and C were also compared between the 2 groups.Results The 2 groups were compatible due to insignificant differences in their preoperative general data and follow-up time(46.9±22.5 months versus 56.3±23.9 months)(P>0.05).The MCSs after operation(3.3±0.3 mm) and at the last follow-up(3.2±0.3mm) in the repair group were significantly shorter than those in the non-repair group(3.8±1.0mm and 3.8±1.2mm)(P<0.05).The rate of radiological MCS malreduction in the repair group(0) was significantly lower than that in the non-repair group(20.4%)(P<0.05).There were no significant differences between the 2 group in rate of surgical failure(0 versus 7.4%),AOFAS ankle-hindfoot score(88.0±5.8 versus 85.9±8.7) or VAS(1.2±0.8 versus 1.6±1.6)(P>0.05).The rate of radiological MCS malreduction for AO/OTA type C ankle fracture in the non-repair group was significantly higher than those for AO/OTA types B and C in the repair group and AO/OTA type B in the non-repair group(P<0.05).Conclusion Surgical repair of the DL rupture may help decrease the rate of postoperative MCS malreduction,especially for AO/OTA type C ankle fractures.
RESUMO
PURPOSE: To evaluate the necessity of deltoid ligament repair in lateral malleolar fracture associated with medial clear space widening. MATERIALS AND METHODS: The 82 cases of 82 patients received surgical treatment for lateral malleolar fracture with medial clear space widening in our hospital from Jan. 1996 to Feb. 2002. 73 male and 9 female patients were included respectively. Average follow-up period was 13.2 month (12~50). The methods of internal fixation of lateral malleolar fracture were 66 cases by cortical screw, 16 by plate and screws, and 9 by transfixing screw. RESULTS: Satisfactory reduction was obtained in 65 of 73 cases by only internal fixation of lateral malleolar fracture. Transfixing screw was needed in 8 cases. There was no need for repair of deltoid ligament. In clinical evaluation, no cases of limitation of movement in ankle was seen at final follow-up time. In radiologic evaluation, average medial clear space widening before operation was 5.89 mm (4.5~13 mm) and that of last follow-up time was 2.54 mm (1.5~3.5 mm). 95.2% was above good result. CONCLUSION: In treatment of unstable lateral malleolar fracture associated with medial clear space widening due to rupture of deltoid ligament, we obtained satisfactory result by accurate anatomical reduction or internal fixation. In these cases, there were no need for repair of deltoid ligament.