The Journal of Bone and Joint Surgery, Vol 69, Issue 9 1346-1352, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Fractures of the distal part of the fibula with associated disruption of the deltoid ligament. Treatment without repair of the deltoid ligament
RA Baird and ST Jackson
Division of Orthopaedic Surgery, University of California, Irvine, Orange 92668.
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.
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