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. 2019 Jun 4:17:87-90.
doi: 10.1016/j.jor.2019.06.005. eCollection 2020 Jan-Feb.

Deltoid ligament repair reduces and stabilizes the talus in unstable ankle fractures

Bennet A Butler  1 , Eric C Hempen  1 , Mauricio Barbosa  1 , Muturi Muriuki  2 , Robert M Havey  2 , Richard W Nicolay  1 , Anish R Kadakia  1
Affiliations

Deltoid ligament repair reduces and stabilizes the talus in unstable ankle fractures

Bennet A Butler et al. J Orthop. .

Abstract

Introduction: Treatment of supination external rotation type IV (SER-IV) ankle injuries has focused on reduction and fixation of the fibula and syndesmosis (ORIF), not repair of the deltoid ligament.

Methods: Twenty-one ankles were analyzed with a motion capture system. Uninjured ankles were stressed and compared to ankles with SER-IV injuries, then with ORIF, and finally ORIF and deltoid repair.

Results: After deltoid ligament repair, talar coronal and axial rotation normalized to the uninjured state and were significantly reduced compared to ORIF alone.

Discussion: Deltoid ligament repair after an SER-IV ankle injury can help directly reduce and stabilize the tibiotalar joint.

Keywords: Ankle fracture; Deltoid ligament; Deltoid ligament repair; Syndesmosis.

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Figures

Fig. 1
Fig. 1
Testing set up with specimen mounted in a material testing machine. Note the green, infrared-emitting flags mounted in the tibia and talus.
Fig. 2
Fig. 2
Comparison of an ankle specimen before and after creation of the SER4 deltoid equivalent injury model. Please note that under minimal loading (1 Nm of external rotation stress) the injury model ankle demonstrates significant widening of the medial clear space.
Fig. 3
Fig. 3
Comparison of an ankle specimen after creation of the ORIF state and then subsequently after creation of the ORIF + deltoid ligament repair state. Please note that under a hanging condition, the talus demonstrates significantly increased eversion in the ORIF state.
See this image and copyright information in PMC

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