Lateral ligament injury of the ankle in children. Follow-up results of primary surgical treatment.

Among 40 acutely injured ankles in children, surgery revealed a cartilaginous and/or bony fragment in 19, and an isolated rupture of the anterior talo-fibular ligament without any lesion of the bone or cartilage in another 17. In four ankles there was no ligament lesion. The lesions were surgically repaired. All ankles healed well and were painless and functionally stable at follow-up. In four ankles radiographs showed a small subfibular fragment, in which bony fusion had failed, but even these ankles were stable. Two other ankles gave a slightly positive sign in the clinical anterior drawer test as compared with the contralateral uninjured ankle, but there were no signs of functional instability nor were there any subjective complaints. Our results suggest that severe ankle sprains in children may cause isolated ruptures of the anterior talofibular ligament and frequently osteochondral lesions. We therefore advocate primary suture of ruptured lateral ligaments of the ankle in children.