- See:
Deltoid Ligament Anatomy:
- Discussion:
- management of
deltoid ligament injuries in association w/ fractures of the
lateral malleolus is controversial;
- both operative and non operative treatment is possible;
- because talus follows fibula when deltoid is ruptured, anatomic restoration of fibula and talus restores medial anatomy & allows medial ligamentous
structures to heal without the need for operative treatment;
- repair of deep deltoid ligament is complicated by its short length & position under the medial malleolus;
- Exam Findings:
- medial ecchymosis appears after 24 hrs when the deltoid ligament has been disrupted);
- Operative Indications:
- exploration of medial side of the ankle should be limited to cases in which the fibula and talus cannot be anatomically reduced:
- reduction may be blocked by interposed fibers of deltoid ligament or interposed posterior tibial tendon;
- evidence for mal-reduction includes
medial clear space is widened by > 2 mm following reduction;
Fractures of the distal part of the fibula with associated disruption of the deltoid ligament. Treatment without repair of the deltoid ligament.
Tibiotalar contact area. Contribution of posterior malleolus and deltoid ligament.
Deltoid ligament integrity in lateral malleolar fractures: a comparative analysis of arthroscopic and radiographic assessments.
Does medial tenderness predict deep deltoid ligament incompetence in supination-external rotation type ankle fractures?
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