Aslam Siddiqui, Maratib Ali, Zeeshan Siddiqui, Ata Ur Rehman.
Assesment of stability of the deltoid ligament in biomallelor ankle fractures after internal fixation.
J Pak Orthop Assoc Jan ;24(2):74-8.

Objective: The stability of the ankle joint is provided by the medial and lateral malleoli and ligaments, the deltoid ligament play important role in stability of ankle joint function. We sought to investigate the competency of the deltoid ligament in patient with an operatively treated bimalleolar ankle fractures. Place and Duration of Study: Department of orthopaedics unit I, Dow University of Health Sciences and Civil hospital Karachi, from May 2010 to April 2011. Study Design: Prospective study Methadology:20 patient with a bimallelor ankle fracture were evaluated. In each patient the medial malleolar was anatomically reduced and fixed. All lateral malleolar injuries were then reduced and fixed . Results: Five ( 26 percent) of the twenty patients had evident incompetence of the deltoid ligament after medial malleolar fixation . This finding was associated with small medial mallaelor fragment. Conclusion: In Bimalleolar fractures the medial injury may be an osseous avulsion and leaving the deltoid intact on the displaced fragments or it may be combination of ligamentous and osseous injury with disruption of the deep portion of the deltoid ligament . It is the injury who involve little osseous and deep posterior portion of deltoid , cause instability of ankle joint it after internal fixation.

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