Bruns J, Dahmen G
Orthopädische Universitätsklinik Hamburg-Eppendorf.
Aktuelle Traumatol. 1987 Oct;17(5):209-13.
Additional ligament ruptures or fractures of the medial side of the ankle joint accompanying the lateral ligament rupture are rare. These injuries are more often in traumas with pronation-eversion movements of the foot. In cases of lateral ligaments ruptures we only found in 2.8% and in 5.9% additional medial injuries. This is confirmed by different biomechanical experiments. Experimentally the delta ligament rupture could mostly be caused by pronation-eversion movements or by forced plantar flexion of the foot. The diagnosis of bony lesions of the medial malleolus might be easy by X-ray, but ligament lesions of the medial ankle joint can be diagnosed easily too be using the stress X-ray controlling the medial talar tilt as a sign of medial instability. Because the necessity of surgical treatment is less important than of the lateral ligaments we recommend this procedure in cases of bilateral instability or if dislocation is obvious.
踝关节外侧韧带断裂时，伴有内侧韧带断裂或骨折的情况较为罕见。这些损伤多见于足部出现旋前-外翻运动的创伤中。在外侧韧带断裂的病例中，我们仅发现2.8%伴有内侧损伤，5.9%伴有其他内侧损伤。不同的生物力学实验证实了这一点。实验表明，三角韧带断裂大多由旋前-外翻运动或足部强迫跖屈引起。通过X线检查，内踝的骨质损伤诊断可能较为容易，但内侧踝关节韧带损伤也可通过应力X线检查来诊断，以内侧距骨倾斜作为内侧不稳定的征象。由于手术治疗的必要性不如外侧韧带断裂那么重要，因此我们建议在双侧不稳定或脱位明显的情况下采用该手术方法。
