Deltoid Ligament Repair Does Not Improve Radiographic or Clinical Outcomes in Weber Type C Pronation-External...

Area of Science:

• Orthopedic Surgery
• Traumatology
• Ankle Biomechanics

Background:

• Weber type C ankle fractures are complex injuries often involving deltoid ligament (DL) damage.
• The clinical utility of DL repair in these fractures remains debated.
• Optimal management strategies aim to restore ankle stability and function.

Purpose of the Study:

• To evaluate the clinical effectiveness of deltoid ligament (DL) repair in Weber type C pronation-external rotation ankle fractures.
• To compare early and late radiographic and clinical outcomes between DL repair and non-repair groups.

Main Methods:

• A randomized controlled trial was conducted involving 71 patients with Weber type C ankle fractures and DL injury.
• Patients were randomized to undergo either DL repair or no repair following fracture fixation.
• Radiographic parameters (medial clear space, talar tilt) and Foot and Ankle Ability Measure (FAAM) scores were assessed at 3, 6, and 12 months postoperatively.

Main Results:

• The deltoid ligament (DL) repair group demonstrated significantly greater talar stability at 3 months postoperatively.
• Transient valgus instability was observed in the no-repair group at 3 months, which resolved by 12 months.
• Both groups showed comparable medial clear space and talar tilt at 12 months, with significant improvement in FAAM scores over time.

Conclusions:

• Deltoid ligament (DL) repair in Weber type C ankle fractures provides enhanced early talar stability.
• While non-operative management may lead to transient instability, functional and radiographic outcomes become similar to repair by one year.
• The findings suggest a potential benefit of DL repair for early stabilization in complex ankle fractures.