Surgical treatment of ankle fractures associated with deltoid ligament rupture

Abstract

Objective To investigate the surgical procedure and the clinical outcome about ankle fractures associated with deltoid ligament complete rupture. Methods From July 2011 to July 2016, 42 patients with ankle fractures associated with deltoid ligament complete rupture in the Orthopaedics of the Affliated Tongji Hospital of Tongji University School of Medicine were retrospectively analyzed. They were 28 males and 16 females with a mean age of 31.6 years (range, 18-72 years). According to the AO/OTA system, 4 fractures were 44-B2, 7 were 44-B3, 10 were 44-C1, 10 were 44-C2, and 11 were 44-C3. Deep and shallow lever of the triangular ligament were determined by preoperative imaging and intraoperative exploration. All cases were treated with fracture reduction and internal fixation plus triangular ligament repair. American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot scores, visual analogue scale(VAS) were used for outcome measurement. Results All wounds healed at the primary stage. Thirty patients were followed up for 18 to 72 months, with the mean follow-up of (36.4±10.3) months. The mean time of bone union was (12.4±2.4) weeks (range, 9-16 weeks). The mean AOFAS ankle-hindfoot score at last follow-up was (85.3±6.2) points (range, 79-100 points). The mean score of VAS was (1.3±0.4) points (range, 0-3 points). There was no ankle instability or arthritis. Conclusions To achieve satisfactory outcomes for patients with ankle fractures associated with deltoid ligament completely rupture, a reasonable surgical procedure should be done.Reduction and internal fixation fractures plus triangular ligament repair can lead good outcomes and prevent complications, such as postoperative pain and ankle instability. Key words: Ankle; Fractures; Surgical procedures; Deltoid ligament