Of four patients who were treated between May 1985 and November 1987 and
who had both a lateral malleolar fracture and a tear of the lateral
ligaments of the ipsilateral ankle, three could be followed. The fractured
malleolus was treated with rigid internal fixation, but the injury to the
lateral ligaments was not diagnosed until the ankle was stressed to test
for stability after the internal fixation. We believe that if disruption of
the lateral ligaments is noted at operation, repair is indicated. This
involves only a slight prolongation of time under anesthesia and markedly
increases the chances for a stable ankle. It is important to check
intraoperatively for a possible tear of the lateral ligaments in a patient
who has a fracture of the ankle, especially when the injury was caused by
high-energy trauma.