A Clinical Study of Disruption of the Deltoid Ligament Associated with Fractures of Distal Fibula / 대한정형외과학회잡지

It is been known that the deltoid ligament of the ankle joint plays an important role in the stabiliy of the ankle joint. In cases of deltoid ligament rupture, associated with lateral malleolar fractures, cannot be maintained the integrity of the mortise and the stability of the talus. Controversy remains about the treatment of deltoid ligament injuries. Many authors advocate an operative repair for deltoid ligament ruptures for optimal reduction of lateral malleolar fracture. However, according to recent cadaveric studies and many satisfactory results of clinical studies, excellent results have been reported regarding the ankle joint stability by anatomical reduction of the lateral structure, but only without surgical repair of the medial structure. Fourteen patients with lateral malleolar fractures with associated deltoid ligament injuries treated at Sun General Hospital between January 1990 and June 1995. There were examined clinically and radiologically. We concluded that deltoid ligament repairs should be considered unnecessary as long as fibular fracture are stabilized anatomically with normal medial joint space. However, in cases with higher fracture levels of lateral malleolus, associated with syndesmotic injury, we recommend syndesmotic screw fixation or deltoid ligament repair.

A Clinical Study of the Treatment of Ruptures of Deltoid Ligament Associated with Fracture of Distal Part of Fibula / 대한정형외과학회잡지

A survey of the literature on the treatment of ruptures of deltoid ligament associated with fracture of distal part of fibula is controversial. Some authors advocated surgical repair of the ruptured deltoid ligament based on the theoretical consideration, while others advocated non-operative treatment based on the clinical consideration. We studied the results in forty-five patients who were treated for disruption of the deltoid ligament and a distal fibular fracture. The length of follow-up in our series was twelve to twenty-four months, with an average of fifteen months. When the fibular fracture was adequately reduced and medial clear space was returned to its normal width, the 91 percents both of patients of being treated with repair of deltoid ligament and patients of being treated without repair had a good or excellent results.