Deltoid ligament repair reduces and stabilizes the talus in unstable ankle fractures

INTRODUCTION: Treatment of supination external rotation type IV (SER-IV) ankle injuries has focused on reduction and fixation of the fibula and syndesmosis (ORIF), not repair of the deltoid ligament. METHODS: Twenty-one ankles were analyzed with a motion capture system. Uninjured ankles were stressed and compared to ankles with SER-IV injuries, then with ORIF, and finally ORIF and deltoid repair. RESULTS: After deltoid ligament repair, talar coronal and axial rotation normalized to the uninjured state and were significantly reduced compared to ORIF alone. DISCUSSION: Deltoid ligament repair after an SER-IV ankle injury can help directly reduce and stabilize the tibiotalar joint.