Rupture of the deltoid ligament in ankle fractures: should it be repaired?

UNLABELLED: In the 2 years after January 1984 we treated 290 fractures of the lateral malleolus in adults, 169 (58 per cent) of them operatively according to the AO-ASIF principles. In 28 fractures (10 per cent) there was also a rupture of the deltoid ligament. These patients were all operated upon, without exploring the medial side of the ankle joint. Postoperative treatment involved movements and partial weight bearing for 6 weeks. These 28 patients were reviewed after an average interval of 18 months. The Weber scoring system was used to assess the results. In 20 cases there was a very good or good result. In eight cases the result was poor. No patient had any sign of medial laxity either clinically or on eversion-stress radiographs. Some patients had signs of osteoarthritis. CLINICAL RELEVANCE: After anatomical reconstruction of the lateral malleolus with perfect congruity of the ankle mortise there is no need to explore and suture the ruptured deltoid ligament. After rigid internal fixation of the lateral malleolus postoperative treatment can allow full function.