Deltoid ligament repair reduces and stabilizes the talus in unstable ankle fractures

Treatment of supination external rotation type IV (SER-IV) ankle injuries has focused on reduction and fixation of the fibula and syndesmosis (ORIF), not repair of the deltoid ligament.Twenty-one ankles were analyzed with a motion capture system. Uninjured ankles were stressed and compared to ankles with SER-IV injuries, then with ORIF, and finally ORIF and deltoid repair.After deltoid ligament repair, talar coronal and axial rotation normalized to the uninjured state and were significantly reduced compared to ORIF alone.Deltoid ligament repair after an SER-IV ankle injury can help directly reduce and stabilize the tibiotalar joint.