Clinical Study of Ankle Fracture Combined With Deltoid Ligament Injury: Repair or Not? A Retrospective, Comparative Study

This study retrospectively evaluated patients with ankle fracture to compare the prognosis between patients who had primary repair of the superficial deltoid ligament and those who did not. A total of 71 patients with ankle frac-ture and fracture-dislocation combined with deltoid ligament injury were divided into 2 groups: repair of superfi-cial layer group (33 cases) and nonrepair group (38 cases). For the repair group, patients first underwent open reduction and internal fixation of the lateral malleolus and received a stress test. If the syndesmosis was widened, it would undergo fixation of the syndesmosis with screws. If instability of the ankle joint was observed, patients might further undergo repair of the superficial deltoid ligament. Ultimately, postoperative functions were evalu-ated using the Philips and Schwartz scale. All patients achieved bony union without significant pain. In the repair group, plantar and dorsi flexions were 2.5 +/- 4.2 degrees (range 0 to 10) and 7 +/- 7.1 degrees (range 0 to 20) less than the normal side, respectively. In the nonrepair group, the plantar and dorsi flexions were 2.8 +/- 4.6 degrees (range 0 to 10) and 6.6 +/- 5.9 degrees (range 0 to 20) less than the normal side. Meanwhile, the Philips and Schwartz scores of the repair and non-repair groups were 92.5 +/- 4.4 (range 80 to 100) and 93.4 +/- 3.8 (range 85 to 100), respectively. But the difference of prognosis between the 2 groups was not statistically significant. In conclusion, for ankle joint fracture combined with deltoid ligament injury, routinely exploring or repairing the deltoid ligament was not recommended, but repair of the deltoid ligament increased stability of the ankle joint in the early postoperative stage. Published by Elsevier Inc. on behalf of the American College of Foot and Ankle Surgeons.