title: [EFFECTIVENESS OF SURGERY IN TREATMENT OF ANKLE FRACTURES ASSOCIATED WITH DELTOID LIGAMENT INJURY].
abstract: OBJECTIVE
  To evaluate the effectiveness of repairing the deltoid ligament with ankle fracture.
  
  
  METHODS
  Between January 2010 and January 2013, 11 patients with ankle fractures associated with deltoid ligament injury were treated. There were 7 males and 4 females, with an average age of 38.2 years (range, 18-72 years). The interval between injury and operation was 6 hours to 7 days (mean, 4 days). According to Lauge-Hansen classification, ankle fracture was rated as pronation-external rotation type in 5 cases, as supination-external rotation type in 4 cases, and as pronation-abduction type in 2 cases. The MRI and color Doppler ultrasound showed deltoid ligament rupture. The results of valgus stress test, talus valgus tilt test, and anterior drawer test after anesthesia were all positive. Fracture was treated by open reduction and internal fixation, and deltoid injury was repaired.
  
  
  RESULTS
  All incisions healed primarily. All patients were followed up 12-18 months (mean, 13.3 months). The X-ray films showed anatomical reduction, good position of internal fixation and stable distal tibiofibular syndesmosis. The mean fracture union time was 7.6 weeks (range, 6-8 weeks). MRI at 3 months after operation showed normal shape of the deltoid ligament. According to American Orthopaedic Foot and Ankle Society (AOFAS) score, the results were excellent in 6 cases, good in 3 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 81.8%.
  
  
  CONCLUSIONS
  It is an effective method to treat ankle fracture with deltoid ligament injury by open reduction and internal fixation of ankle fracture and repair of the deltoid ligament injury, which can effectively rebuild medial instability and has satisfactory effectiveness.
authors.forename: Haipeng
authors.initials: H
authors.lastname: Wang
authors.forename: Zhengrong
authors.initials: Z
authors.lastname: Gu
authors.forename: Yunji
authors.initials: Y
authors.lastname: Liu
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
authors.forename: Jiahua
authors.initials: J
authors.lastname: Jan
authors.forename: Jionghao
authors.initials: J
authors.lastname: Zhang
authors.forename: Cheng
authors.initials: C
authors.lastname: Peng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064386:Ankle Fractures / Q000175:diagnosis* / Q000601:surgery*; D016512:Ankle Injuries / Q000150:complications / Q000601:surgery*; D000843:Ankle Joint / Q000503:physiopathology; D057645:Deltoid Muscle; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008022:Ligaments; D008023:Ligaments, Articular / Q000293:injuries; D008297:Male; D008875:Middle Aged; D009038:Motion; D009985:Orthopedics / Q000379:methods*; D012399:Rotation; D013484:Supination; D016896:Treatment Outcome; D055815:Young Adult