Surgical treatment of ankle fractures associated with complete rupture of the deltoid ligament

Abstract

Objective To investigate the surgical procedure and clinical outcome of treatment of ankle fractures associated with completer rupture of the deltoid ligament.Methods From January 2006 to December 2010,we treated 48 cases of ankle fracture associated with complete rupture of the deltoid ligament rupture.They were 26 males and 22 females,with an average age of 44.2 years (range,17 to 74 years).According to the Lauge-Hansen classification,there were 14 cases of supination-external rotation type Ⅳ,12 pronation-external rotation type Ⅲ,16 pronation-external rotation type Ⅳ and 5 pronation-abduction type Ⅲ.According to the AO/OTA system,there were one case of 43-B2,3 cases of 44-B2,16 44-B3,7 44-C1,844-C2,and 13 44-C3.Reduction and fixation of the fracture and repair of the ruptured ligament were conducted simultaneously for all patients.Clinical examinations,radiographs,American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot scores and visual analogue scale (VAS) were used for outcome measurement.Results All wounds healed at the first stage.Forty-three patients were followed up for 12 to 32 months,with an average of 19 months.The mean time for bone union was 13.2 weeks (range,10 to 16 weeks).The mean AOFAS ankle-hindfoot score at the last follow-up was 93.4 points (range,83 to 100 points).The mean VAS score was 1.2 points (range,0 to 6 points).There was no ankle instability.Conclusion To achieve satisfactory outcomes for patients with ankle fractures associated with complete rupture of the deltoid ligament,a proper surgical procedure should be chosen according to reasonable preoperative evaluation and a proper suture technique according to the rupture site of the deltoid ligament. Key words: Ankle joint; Fractures fixation, internal; Suture techniques; Deltoid ligament