Deltoid Ligament Reconstruction in Lateral Malleolus Fractures with Deltoid Rupture

Background: Treatment of lateral malleolus fractures is a controversial issue, especially when is associated with deltoid ligament (DL) rupture Objectives: In the present study, the effect of DL repair in patients with lateral malleolar fractures with deltoid rupture was investigated on medial clear space (MCS), ankle-hindfoot score (AHS), and malreduction rates. Methods: ۶۵ patients who referred with lateral malleolus fracture plus DL rupture during ۲۰۱۷-۲۰۱۸ and underwent surgery were studied. The diagnosis was conducted by a single renowned orthopedic surgeon according to physical examination, clinical, and paraclinical findings such as radiography. A questionnaire was used to record  demographic information, pain severity, duration of follow-up, AO classification, pre- and postoperative MCS, AHS, and malreduction and data of the patients with and without DL reconstruction were compared using SPSS software (version ۲۱). Results: About half of the patients (۵۱%) were men. DL was reconstructed in ۵۰.۸% of the patients. AO category of the most (۵۳.۸%) of the patients was class-B. There was no difference between the patients with and without DL reconstruction in the frequency of fibular malreduction, mean pain severity, and AHS (P>۰.۰۵). Mean MCS was neither different between the groups before (P=۰.۹۴۶), nor after surgery (P=۰.۷۹۴). Mean change in MCS score was -۲.۰۳±۰.۹۵ and -۱.۹۴±۰.۹۵ in the groups with and without DL reconstruction, respectively (P=۰.۶۰۶). Conclusion: This study showed that DL reconstruction did not affect the medial clearance space. Further studies are required on stability and biomechanics to determine which injuries need surgery and which ones need conservative treatment.