[Clinical aspects and therapy of fibular ligament ruptures in childhood]

Injuries to the lateral ligament of the ankle are frequently encountered in adolescence and require just as much care in diagnosis and management as in adults. There is a strikingly high rate of tears with an avulsion of the bony or cartilaginous insertion of the anterior talo-fibular ligament in younger children. The most likely causes are the higher elasticity and strength of ligaments, as well as the special situation of ligament insertion during growth. Experience has shown operative treatment to be superior to conservative measures. Only a surgical procedure can allow exact adaptation of the ruptured ligaments and especially a reinsertion of cartilaginous or bony fragments after avulsion injury. Old tears often make a reinsertion very difficult if not impossible. In these cases, resection of the fragments and reconstruction of ligaments are suggested if necessary. For more operative and technical details, the recently edited monograph from Zwipp should be consulted; it also contains many interesting points regarding the physiology, pathology and clinical importance of injuries to the lateral ligament of the ankle.