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KMID : 0361620100450030210
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Journal of the Korean Orthopaedic Association
2010 Volume.45 No. 3 p.210 ~ p.215
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Treatment of Lateral Malleolar Fracture Associated with Disruption of the Deltoid Ligament
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Song Kyung-Sub
Kim Hyung-Gyu
Park Byeong-Mun
Moon Chan-Sam
Kim Byeong-Yeon
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Abstract
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Purpose: To evaluate the necessity for repair of associated deltoid ligament rupture in lateral malleolar fracture.
Materials and Methods: Twenty of twenty-fi ve patients were evaluated. Each received surgical treatment without repair of the ruptured deltoid ligament. We found that the medial clear space was widened more than 5 mm in intraoperative stress tests which had been done between May 2003 and June 2008. We did follow-up on these patients for more than 1 year after surgery. At the fi nal follow-up, radiologic and clinical assessment were evaluated on plain X-ray and according to Olerud Molander ankle scores.
Results: Open reduction and internal fi xation of the lateral malleolar was done in all cases and an additional transfi xation screw was needed in 17 patients who had concurrent syndesmotic disruption. Average medial clear space widening before surgery was 9.28 mm (7.0-17.14 mm), at fi nal follow-up time it was 3.43 mm (2.9-5.28 mm). And there were 8 (40%) good, 10 (50%) fair and 2 (10%) poor ratings on radiologic evaluation, but the mean clinical score was 93.75, with 17 (85%) being excellent, 2 (10%) good and 1 (5%) fair on clinical evaluation.
Conclusion: In the treatment of lateral malleolus fracture associated with disruption of the deltoid ligament, satisfactory clinical results could be obtained including lateral joint stability, with accurate anatomical reduction and internal fixation of the lateral malleolus and distal tibio-fi bular joints. Medial joint stability could be obtained without deltoid ligament repair.
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KEYWORD
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lateral malleolar fracture, disruption of deltoid ligament
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