Analysis Of The Curative Effect Of Surgical Repair Of The Deltoid Ligament Rupture In The Treatment Of Ankle Joint Injury

Objective:To investigate the therapy method and clinical effect of ankle fracture combined with deltoid ligament rupture,provide the reference for clinical work. Methods:From December 2013 to October 2015, we selected 43 patients of ankle fractures combined with deltoid ligament rupture.Twenty-three patients were treated with anatomical reduction and rigid internal fixation plus deltoid ligament repair(repair group).There were 13 males and 10 females,with an average of 43.61 years(range from 24 to 61 years).According to the Lauge-Hansen classification system,9 cases were supination-external rotation type,11 cases were pronation-external rotation,and 3 were pronation-abduction type.According to the AO/OTA classification system,there were 5 cases of 44-B2,7 cases of 44-B3,3 cases of 44-C1,5 cases of 44-C2,3 cases of 44-C3.The other 20 patients obtained only anatomical reduction and rigid internal fixation(control group),including 12 males and 8 females,with an average of 44.40 years(range from 26 to 62 years).According to the Lauge-Hansen classification system,8 cases were supination-external rotation type,9 cases were pronation-external rotation,and 3 were pronation-abduction type.According to the AO/OTA classification system,there were 5 cases of 44-B2,6 cases of 44-B3,4 cases of 44-C1,3 cases of 44-C2,2 cases of 44-C3.Regular callback,follow-up,radiografh,clinical examination were used for recording the time of bone union,with or without complications,American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot scores and visual analogue scale(VAS).By comparing the two groups of time and score,get statistical results and clinical significance. Results:All patients obtained wound healing at the first stage.They were followd up for 6 to 26 months,with an average period of 16.53 months.The mean time for bone union at repair group was 13 weeks(range from 10 to 16 weeks).At the last follow-up,the mean score of AOFAS ankle-hindfoot was 91.48 points(range from 74 to 100 points), and the mean score of VAS was 1.22 points(range from 0 to 5 points).The mean time for bone union at control group was 13 weeks(range from 11 to 16 weeks).At the last follow-up,the mean score of AOFAS ankle-hindfoot was 85.25 points(range from 72 to 100 points), and the mean score of VAS was 2.20 points(range from 0 to 6 points).All patients was no ankle instability.There was no significant difference in the time for bone union and VAS score between two groups(P>0.05).While there was obvious meaning in the score of AOFAS ankle-hindfoot at the last follow-up between two groups(P<0.05). Conclusion :The effect of repair with deltoid ligament rupture was better than no repair during the treatment of ankle fracture with open reduction inteanal fixation.But,whether need to repair the deltoid ligament rupture depends on reasonable clinical evaluation.