Operative Treatment of Acute Lateral Ligament Complex Injuries

ABSTRACT

PURPOSE: The purpose of this study is to elucidate the clinical features of the acute lateral ligamentous complex injuries and evaluate the postoperative results. MATERIALS AND METHODS: Between 1991 and 1997, 27 patients (28 cases) were treated surgically for acute lateral ligament complex injuries. All cases showed 2+ or more varus instability and were treated within 6 weeks after trauma. 20 cases combined other ligamentous injuries and 8 cases had isolated injuries. Among the lateral ligament complex the lateral collateral ligament was ruptured in all cases. Meniscal injuries were associated in 12 cases and 5 cases showed common peroneal nerve injury but no cases showed vascular injuries. RESULTS: On Telos stress X-ray, the varus stability was improved from 2,12+(mean 8.6mm) to 0.50+(mean 2.8mm) in isolated injuries and from 2.95+(mean 9.5mm) to 1.10+(4.5mm) in combined injuries. Cases with isolated injury showed no C and D grade on IKDC subjective evaluation, ligament evaluation and range of motion evaluation. Cases of combined injuries showed 5C and 3D on subjective evaluation, 3C and 2D on ligament evaluation, 3C and 1D on range of motion evaluation. Most common postoperative complication was joint stiffness, of which 2 cases were treated with arthroscopic adhesiolysis. CONCLUSION: Prognosis in isolated cases was good and the results were influenced with combined injuries. To reduce postoperative complications a secure fixation and early rehabilitation was recommended. Our study supports the notion that operation performed at an early stage in fresh injuries with a varus instability of 2+ or more gives improved stability as a final result.