Zeegers A V, van der Werken C
Department of Surgery, St Elisabeth Hospital, Tilburg, The Netherlands.
Injury. 1989 Jan;20(1):39-41. doi: 10.1016/0020-1383(89)90043-0.
In the 2 years after January 1984 we treated 290 fractures of the lateral malleolus in adults, 169 (58 per cent) of them operatively according to the AO-ASIF principles. In 28 fractures (10 per cent) there was also a rupture of the deltoid ligament. These patients were all operated upon, without exploring the medial side of the ankle joint. Postoperative treatment involved movements and partial weight bearing for 6 weeks. These 28 patients were reviewed after an average interval of 18 months. The Weber scoring system was used to assess the results. In 20 cases there was a very good or good result. In eight cases the result was poor. No patient had any sign of medial laxity either clinically or on eversion-stress radiographs. Some patients had signs of osteoarthritis.
After anatomical reconstruction of the lateral malleolus with perfect congruity of the ankle mortise there is no need to explore and suture the ruptured deltoid ligament. After rigid internal fixation of the lateral malleolus postoperative treatment can allow full function.
1984年1月后的两年里，我们治疗了290例成人外踝骨折，其中169例（58%）根据AO - ASIF原则进行了手术治疗。28例骨折（10%）同时伴有三角韧带断裂。这些患者均接受了手术治疗，未探查踝关节内侧。术后治疗包括6周的活动和部分负重。这28例患者平均在18个月后接受了复查。采用Weber评分系统评估结果。20例结果为优或良。8例结果为差。无论是临床检查还是外翻应力X线片检查，均无患者出现内侧松弛的迹象。部分患者有骨关节炎的体征。
在外踝进行解剖重建且踝关节 mortise 完全吻合后，无需探查并缝合断裂的三角韧带。外踝进行坚强内固定术后，治疗可实现完全功能恢复。
