Different managements of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the clinical outcomes of different managements of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture.Methods From January 2010 to June 2014,33 cases of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture were treated with open reduction and internal fixation.According to the different managements of the complete rupture of the deltoid ligament,the patients were divided into 4 groups9 cases in the non-repair group,7 cases in the superficial layer repair group,9 cases in the deep layer repair group,and 8 cases in the complete repair group.All the patients took anteroposterior,lateral and gravity stress radiographs preoperatively and postoperatively.The 4 groups were compatible in preoperative general data (P ＞ 0.05).The 4 groups were compared in terms of operation time,medial clear space and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.Results All the patients were followed up for 6 to 18 months (average,13.7 months).All wounds healed at the first stage without any infection.All fractures united primarily after 3 to 9 months (average,4.7 months).The operation time for the superficial layer repair group was significantly longer than for the non-repair group,but significantly shorter than for the deep layer repair and the complete repair groups (P ＜ 0.05).In gravity stress radiographs,there was no significant difference in medial clear space among the 4 groups (P ＞ 0.05),but there were significant differences before and after operation in the 4 groups (P ＜ 0.05).The postoperative AOFAS ankle-hindfoot score in the repair groups was significantly higher than in the non-repair group and the superficial layer repair group(P ＜ 0.05).Conclusion To achieve satisfactory outcomes for patients with complete rupture of the deltoid ligament associated with supination-external rotation ankle fractures,anatomic open reduction and rigid internal fixation is necessary,and repair of the deltoid ligament,especially its superficial layer,is a valuable contribution.