Fractures of the distal part of the fibula with associated disruption of the deltoid ligament. Treatment without repair of the deltoid ligament

Abstract

The results in twenty-four patients who were treated for a distal fibular fracture and disruption of the deltoid ligament were studied, using subjective, objective, and radiographic criteria, over a period of at least two years. Nineteen (90 per cent) of the twenty-one patients who were treated without repair of the deltoid ligament had a good or excellent result. All but two of these patients were unrestricted in the ability to walk and run and had no pain during the activities of daily living. No patient had instability of the ankle. At follow-up, the range of motion of the ankle was within 15 degrees of that of the uninjured ankle in 90 per cent of the patients. Only one ankle had radiographic evidence of narrowing of the joint space. The three patients in whom the deltoid ligament was repaired did not have as good a result as the twenty-one patients in whom it was not, but this group was too small to permit valid comparisons. We concluded that exploration of the medial side of the ankle and repair of the deltoid ligament are not necessary unless reduction of the lateral malleolus fails to reduce the talus within the ankle mortise.