Is Medial Tenderness Predictive of Deep Deltoid Ligament Incompetence in Supination-External Rotation Type Ankle Fractures?
Purpose: We prospectively determined whether tenderness in the region of the deltoid ligament is predictive of deep deltoid ligament incompetence in the presence of an isolated lateral malleolus fracture without radiographic evidence of medial clear space widening/lateral talar shift. Methods: This institutional review board-approved study included, over a 9-month period, all patients who had an acute isolated Weber B (OTA 44-B) fibula fracture without radiographic evidence of lateral talar subluxation/medial clear space widening. Each patient was evaluated for tenderness to palpation in the region of the deltoid ligament on the medial side of the ankle. Deep deltoid incompetence was defined as widening of the medial clear space on an external rotation stress mortise radiograph. Results: Fifty-five patients met the criteria for the study. The results are summarized below: • Tenderness/widening (true positive): 13 • Tenderness/ no widening (false positive): 13 • No Tenderness/ no wideni
