Deltoid Ligament: An Anatomical Evaluation of Function

Harper, Marion C.

doi:10.1177/107110078700800104

Cited by 157 publications

(80 citation statements)

References 7 publications

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“…In the setting of lateral malleolus fracture, a 1956 experiment by Close revealed that the talus could be laterally shifted a distance of 3.7 mm only after the complete rupture of the superficial and deep components of the deltoid ligament 10 . In 1976, Harper showed that even in the setting of an intact lateral malleolus, the talus could tilt 11 and become unstable with deltoid ligament disruption 11 . Therefore, suturing the deltoid ligament may help to restore ankle stability.…”

Section: Management Of Acute Deltoid Ligament Injurymentioning

confidence: 99%

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Treatment of Medial Malleolus or Pure Deltoid Ligament Injury in Patients with Supination‐External Rotation Type IV Ankle Fractures

Wang

Zhang

Yin

et al. 2017

Orthopaedic Surgery

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Objective: To investigate the effect of internal fixation on postoperative ankle function in patients with supinationexternal rotation type IV ankle fractures, including medial malleolus fractures and deltoid ligament injury.Methods: Between January 2012 and June 2014, patients with medial structure injuries were enrolled in this study and assigned to the medial malleolus fracture group or the deltoid ligament group. The surgical procedures for the two groups were documented. The follow-up endpoint was the time point when the steel plate or screw was removed from the lateral ankle. The Olerud-Molander ankle scoring system was used to assess ankle function.Results: A total of 84 patients with supination-external rotation type IV ankle fractures had complete medical records and were included in this study. The average age of the patients was 44.16 years (range, 15-75). The patient sample included 39 males and 45 females. Overall, 49 patients (19 males and 30 females) suffered a medial malleolus fracture. The average age of these patients was 40.20 years (range, 15-75). Patients with a posterior malleolar fracture fragment >25% of the articular surface accounted for 81.6% (40 patients) of these patients. Overall, 35 patients (20 males and 15 females) experienced a deltoid ligament injury. The average age of these patients was 44.21 years (range, 17-73). Patients with a posterior malleolar fracture fragment >25% of the articular surface accounted for 11.5% (four patients) of these patients. Open reduction was performed in patients with medial malleolus fractures, and two 4.0-mm cannulated screws were used to fixate the posterior malleolus and the medial malleolus. The sutureanchor technique was used to repair the ligaments in patients with deltoid ligament injuries. The follow-up endpoint was the time point when the steel plate and screws were removed from the lateral ankle in patients. The average follow-up period was 13.4 months (range, 11-17). The Olerud-Molander ankle scoring system was used to assess postoperative ankle function. The average score for the patients in the medial malleolus fracture group was 90.3 points (range, 85-95). The average score for the patients in the deltoid ligament injury group was 87.7 points (range, 80-95). No significant differences were found in the scores between the two groups. Conclusion:Medial malleolus fracture and deltoid ligament injury are two different presentations of supinationexternal rotation type IV ankle fractures. Anatomic reduction of the articular surface concurrent with restoration of ankle stability can achieve favorable results for these two injuries.

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Section: Management Of Acute Deltoid Ligament Injurymentioning

confidence: 99%

“…The average follow-up period was 13.4 months (range, [11][12][13][14][15][16][17]. The Olerud-Molander ankle scoring system was used to assess postoperative ankle function.…”

Section: Follow-upmentioning

confidence: 99%

Treatment of Medial Malleolus or Pure Deltoid Ligament Injury in Patients with Supination‐External Rotation Type IV Ankle Fractures

Wang

Zhang

Yin

et al. 2017

Orthopaedic Surgery

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“…A SER IV injury consists of a lateral malleolar fracture with a deep deltoid ligament disruption, a medial malleolar fracture, or both. Operative Wxation of the Wbular fracture is usually required in SER IV ankle fractures [4,13,19,21,37,52,54,58]. In the case of a medial malleolar fracture associated with deltoid ligament injury, Wxation of the medial malleolus may not restore ankle joint stability and an internal Wxation of Wbular fracture may be necessary [6,48,49,52].…”

Section: Introductionmentioning

confidence: 99%

“…The deep deltoid ligament originates on the posterior border of the anterior colliculus, the intercollicular groove, and posterior colliculus of the tibia and it is oriented transversely and inserts into the entire nonarticular surface of the medial talus. A rupture of the deep deltoid ligament results in ankle instability after distal Wbular fracture [19,21,30,31,37,42,43,52]. The stability of the loaded ankle is primarily due to the deltoid ligament, which exerts a restraining inXuence on the external rotation of the talus [31].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature

Bekerom

Mutsaerts

Dijk

2008

Arch Orthop Trauma Surg

112

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Background and purpose Review the literature concerning modalities to evaluate the integrity of the deltoid ligament in patients with supination external rotation ankle fractures. Methods The electronic databases Pubmed/Medline, CINAHL and Embase were searched from 1987 to November 2007 to identify all published original studies concerning diagnostic modalities to evaluate the integrity of the deltoid ligament in adult ankle fractures. Results This review included nine studies involving 423 ankle fractures. Three trails investigated medial tenderness; two studies, ecchymosis; two studies, swelling; one study, an injury radiograph; six studies, a type of radiographic stress view; one study, the Lauge-Hansen classiWcation; one study, MRI; and one article studied arthroscopy in the evaluation of the deltoid ligament integrity. Interpretation Swelling, ecchymosis, medial tenderness, initial injury radiographs and the Lauge-Hansen classiWcation are less adequate predictors of the integrity of the deltoid ligament. Manual or the less painful variant, the gravity external rotation stress radiographs are considered the gold standard. The amount of medial clear space widening indicative of a positive external rotation stress test has been somewhat variable in the literature but ¸5 mm is generally regarded as most reliable. Achieving adequate external rotation of the foot when obtaining stress radiographs is more important than positioning the ankle in the appropriate degree of ankle Xexion. The amount of applied force necessary when performing an external rotation stress radiograph is not well deWned and mainly determined by the patient's pain level. The indication for surgery should not be based on the absolute value of one parameter but on the combination of several parameters. If nonoperative treatment is chosen despite a positive stress radiograph, close follow-up is critical because subluxation of the ankle joint is still possible. MRI could be useful in individual cases.

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“…Dies stellt einen Bremsmechanismus dar, der einenzu steilen Spannungsanstiegin der Endphase der Bewegung vermeiden hilft. Eine weitere Aufgabe des medialen Bandapparates liegt in der Begrenzung der Abknickung nach lateral (Valgusbeanspruchung [ 10]). Damit wird einerseits das Aufklappen des oberen Sprunggelenks verhindert, andererseits wird damit auch die Pronationsbewegung des unteren Sprunggelenks begrenzt.…”

Section: Sprunggelenkeunclassified

Funktionelle Anatomie des Fußes

Klumpfuß

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Deltoid Ligament: An Anatomical Evaluation of Function

Cited by 157 publications

References 7 publications

Treatment of Medial Malleolus or Pure Deltoid Ligament Injury in Patients with Supination‐External Rotation Type IV Ankle Fractures

Treatment of Medial Malleolus or Pure Deltoid Ligament Injury in Patients with Supination‐External Rotation Type IV Ankle Fractures

Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature

Funktionelle Anatomie des Fußes

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