Postoperative Stability in Displaced Ankle Fractures With Concomitant Ligamentous Injuries

• Published in: The Journal of foot and ankle surgery 2024-09, Vol.63 (5), p.508-512
• Main Authors: Choi, Ji Hye, Choi, Yoon Hyo, Kim, Jung Geul, Koo, Seungbum, Lee, Kyoung Min
• Format: Article
• Language: English
• Subjects: Adult; Aged; ankle fracture; Ankle Fractures - diagnostic imaging; Ankle Fractures - surgery; Ankle Injuries - complications; Ankle Injuries - diagnostic imaging; Ankle Injuries - surgery; Ankle Joint - diagnostic imaging; Ankle Joint - physiopathology; Ankle Joint - surgery; ankle stability; deltoid injury; Female; Fracture Fixation, Internal - methods; Humans; Joint Instability - etiology; Joint Instability - surgery; Ligaments, Articular - diagnostic imaging; Ligaments, Articular - injuries; Ligaments, Articular - surgery; Male; Middle Aged; Radiography; Retrospective Studies; stress ankle radiograph; syndesmosis fixation; Treatment Outcome; Young Adult
• ISSN: 1067-2516; 1542-2224; 1542-2224
• DOI: 10.1053/j.jfas.2024.04.003

Ankle instability, which can be attributed to either the deltoid or lateral ligamentous complex, may be both a cause and a consequence of ankle fractures. This study aimed to assess postoperative ankle instability in patients with displaced ankle fractures. A total of 54 patients with displaced ankle fractures were included. Malleolar fractures were surgically reduced and fixated, and if necessary, the syndesmosis was stabilized. Concomitant deltoid injuries were left unrepaired. Ankle stress radiographs were taken approximately 25.4 months after surgery, with a standard deviation of 20.5 months. Radiographic measurements included the tibiotalar tilt angle (TT) on varus stress view, anterior translation of the talus (AT) on the anterior drawer view, and the medial clear space (MC) and tibiotalar tilt angle on the valgus stress view. These measurements were compared between the injured and the noninjured contralateral ankle for all patients as well as in a subgroup of 19 patients with concomitant deltoid and syndesmosis injuries. There were no significant differences in Varus TT (p = .675, p = .394), AT (p = .516, p = .967), Valgus MC (p = .190, p = 0.498), and Valgus TT (p = .173, p = .442) between the injured and noninjured ankles in the whole group of patients as well as in the subgroup of patients with concomitant deltoid and syndesmosis injuries. Patients with displaced ankle fractures exhibited radiographically stable ankles postoperatively. Syndesmosis fixation without deltoid ligament repair is a viable treatment option for achieving ankle stability postoperatively in fractures with both ligament injuries.