Different managements of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture

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 groups: 9 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), 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. Key words: Ankle joint; Fractures, bone; Ligament; Surgical procedures, operative; Ligament repair