The contribution of anterior deltoid ligament to ankle stability in isolated lateral malleolar fractures |
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| Institution: | 1. Department of Orthopaedic Sugery, Guro Hospital, College of Medicine, Korea University, Seoul, Korea;2. Department of Orthopaedic Sugery, Ansan Hospital, College of Medicine, Korea University, Gyeonggido, Korea;3. Department of Radiology, Guro Hospital, College of Medicine, Korea University, Seoul, Korea;1. KU Leuven – University of Leuven, Faculty of Medicine, B-3000 Leuven, Belgium;2. University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium;3. University Hospitals Leuven, Care Program Management, B-3000 Leuven, Belgium;4. KU Leuven – University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium;1. The Orthopaedic Trauma Unit, Division of Orthopaedics, University of Alabama at Birmingham, United States;2. Talpiot Medical Leadership Program, Sheba Medical Centre, Israel;1. Service d’Anesthésie-Réanimation, Hôpital Européen Georges Pompidou, Université Paris 5 Descartes, Sorbonne Paris Cite, Paris, France;2. Department of Anesthesia and Perioperative Care, San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, USA;3. Département de Biostatistique et Informatique Médicale, INSERM U1153, équipe ECSTRA, Hôpital Saint Louis, Université Paris Diderot, Sorbonne Paris Cite, Paris, France;4. SAMU 92, Hôpital Raymond Poincare, Université de Versailles St Quentin, Garches, France;5. Division of Biostatistics, School of Public Health, University of California Berkeley, Berkeley, USA;1. Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, PR China;2. Beijing Institute of Respiratory Medicine, Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China;1. Ilizarov Unit S.C Ortopedia e Traumatologia, Manzoni Hospital, Lecco, Italy;2. Department of Orthopedic and Trauma, Postgraduate Medical Institute Hayatabad, Medical Complex, Peshawar, Pakistan |
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| Abstract: | The treatment of isolated lateral malleolar fractures with deltoid ligament rupture remains controversial. We prospectively analysed 35 patients with isolated lateral malleolar fractures during 2006–2013. Radiography and magnetic resonance imaging (MRI) were performed to assess the degree of reduction, ligament damage, and stability. Internal fixation was performed for all unstable valgus fractures with unacceptable fracture parameters. Fractures with residual valgus instability after fixation underwent anterior deltoid repair. The mean anterior deltoid ligament grade based on MRI was significantly different between the high-grade unstable group and the stable and low-grade unstable groups (p = 0.037 and 0.004, respectively). Postoperative medial clear space measurements were not significantly different between groups. MRI was shown to be a useful tool in the preoperative identification of isolated lateral malleolus fractures prone to valgus instability. In the case of high-grade unstable fractures of the lateral malleolus, repair of the anterior deltoid ligament is adequate for restoring medial stability. |
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| Keywords: | Superficial deltoid ligament Anterior deltoid ligament Medial ankle instability Isolated lateral malleolus fracture |
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