Fracture-dislocation of the ankle with rupture of the deltoid ligament.

Rupture of the deltoid ligament usually occurs in association with a fracture of the fibula. While reduction and internal fixation of the fibula is usually recommended, the deltoid ligament is left unrepaired. A 15-month follow-up of 30 patients with such injuries revealed that 41 per cent of the patients continued to experience pain while walking and 34 per cent were restricted by the pain in their activities. In 34 per cent of patients these symptoms originated from chronic overuse of the attenuated deltoid ligament rather than ankle instability which, though present in 17 per cent of cases, was rarely the cause of symptoms. Surgical treatment of these injuries resulted in morbidity and a poor symptomatic and functional result in 41 per cent of patients.