Abstract
Category:
Ankle
Introduction/Purpose:
To evaluate the effect of repairing deltoid ligament in patients with supination-external rotation type? ankle fractures.
Methods:
Between January 2013 and June 2016, 35 patients of supination-external rotation type? ankle fractures associated with deltoid ligament injury had complete medical records and were included in this study. Among all, 30 cases involved pure deltoid ligament injuries while others also included medial malleolus fractures. All fractures were treated by open reduction and internal fixation. Patients were assigned to the repaired group (21 patients) or the non-repaired group (14 patients) according to whether deltoid ligament injuries were treated during the surgery. No significant difference was found in gender, age, injury pattern, time from injury to operation(P>0.05), which was comparable. Medial clear space, visual analogue scale(VAS) score, and American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score(6 months, one year, two years after surgery), Baird-Jackson scoring system and complications were recorded.
Results:
Thirty-five patients were followed up 21-28months.The mean duration of operation in the repaired group was significantly longer than that of the non-repaired group.Baird-Jackson scoring system: the excellent rate of the repaired group was 90.5% while the non-repaired group was 85.7% . The VAS scores and the medial clear space of preoperative and final follow-up were significantly improved. At the last follow-up,2.85 percent of the patients presented with ankle instability while 8.5 percent of them occured traumatic arthritis. The AOFAS scores at 6, 12, and 24 months after operation were (82.1 ± 6.6; 86.2 ± 5.9; 91.5 ± 5.8) and (78.1 ± 6.5; 83.9 ± 5.6; 90.3 ± 5.6). However, none of them showed significant difference between the two groups (P>0.05).
Conclusion:
It’s unnecessary to repair the deltoid ligament in patients with supination-external rotation type? ankle fractures when ankle mortise restores after the fractures are fixed.