2016Praxis medicaOpen access

Functional results of surgical treatment of deltoid ligament rupture as components of fracture of the lateral malleolus

Dejan Tabaković, R Grbić, Marko Kadija, A. Vasić, Božidar Odalović, Saša Tabaković, Radovan Manojlović

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Abstract

Injury of the deltoid ligament as a component of the lateral malleolus fractures is caused by the fact rotational forces during the support. The aim of this research is to examine the functional results of the patient who had undergone suture of the deltoid ligament and osteosynthesis of fracture of the lateral malleolus. In a retrospective study the analysis included a series of 45 patients.The diagnosis of rupture of the deltoid ligament is made based on physical findings islands and tenderness in the region of the deltoid ligament and roentgenographic confirmation width of the medial joint space > 4 mm. There is a high degree of correlation with the 25 (55.55%) patients between excellent functional outcomes of treatment calculated by Gregory[11] score and great roentgenographic findings by Konrath score[12]. The total clinical scores of subjective and objective clinical assessment by Gregory of a sample of patients, characterized by an excellent, even with the 40 (88.89%) patients. In the literature there is no agreement on the method of treatment of the deltoid ligament rupture associated with fractures of the lateral malleolus. Based on theoretical considerations, a number of authors advocate surgical treatment discontinued deltoid ligament. In our series, using suture of the deltoid ligament and osteosynthesis of the lateral malleolus, the best results are obtained with the PAB fracture, lower percentages of excellent results is with the SER fractures. The worst result was obtained with the PER type fracture. Anatomical and functional integrity of all parts of the talocrural joint that allows harmony of movement and stability is achieved with osteosynthesis of lateral malleolus and suture of the deltoid ligament.

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Injury of the deltoid ligament as a component of the lateral malleolus fractures is caused by the fact rotational forces during the support. The aim of this research is to examine the functional results of the patient who had undergone suture of the deltoid ligament and osteosynthesis of fracture of the lateral malleolus. In a retrospective study the analysis included a series of 45 patients.The diagnosis of rupture of the deltoid ligament is made based on physical findings islands and tenderness in the region of the deltoid ligament and roentgenographic confirmation width of the medial joint space > 4 mm. There is a high degree of correlation with the 25 (55.55%) patients between excellent functional outcomes of treatment calculated by Gregory[11] score and great roentgenographic findings by Konrath score[12]. The total clinical scores of subjective and objective clinical assessment by Gregory of a sample of patients, characterized by an excellent, even with the 40 (88.89%) patients. In the literature there is no agreement on the method of treatment of the deltoid ligament rupture associated with fractures of the lateral malleolus. Based on theoretical considerations, a number of authors advocate surgical treatment discontinued deltoid ligament. In our series, using suture of the deltoid ligament and osteosynthesis of the lateral malleolus, the best results are obtained with the PAB fracture, lower percentages of excellent results is with the SER fractures. The worst result was obtained with the PER type fracture. Anatomical and functional integrity of all parts of the talocrural joint that allows harmony of movement and stability is achieved with osteosynthesis of lateral malleolus and suture of the deltoid ligament.

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Available abstract

Injury of the deltoid ligament as a component of the lateral malleolus fractures is caused by the fact rotational forces during the support. The aim of this research is to examine the functional results of the patient who had undergone suture of the deltoid ligament and osteosynthesis of fracture of the lateral malleolus. In a retrospective study the analysis included a series of 45 patients.The diagnosis of rupture of the deltoid ligament is made based on physical findings islands and tenderness in the region of the deltoid ligament and roentgenographic confirmation width of the medial joint space > 4 mm. There is a high degree of correlation with the 25 (55.55%) patients between excellent functional outcomes of treatment calculated by Gregory[11] score and great roentgenographic findings by Konrath score[12]. The total clinical scores of subjective and objective clinical assessment by Gregory of a sample of patients, characterized by an excellent, even with the 40 (88.89%) patients. In the literature there is no agreement on the method of treatment of the deltoid ligament rupture associated with fractures of the lateral malleolus. Based on theoretical considerations, a number of authors advocate surgical treatment discontinued deltoid ligament. In our series, using suture of the deltoid ligament and osteosynthesis of the lateral malleolus, the best results are obtained with the PAB fracture, lower percentages of excellent results is with the SER fractures. The worst result was obtained with the PER type fracture. Anatomical and functional integrity of all parts of the talocrural joint that allows harmony of movement and stability is achieved with osteosynthesis of lateral malleolus and suture of the deltoid ligament.

Key concepts: Deltoid ligament, Medicine, Lateral malleolus, Malleolus, Ligament, Deltoid curve, Surgery, Osteosynthesis

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