Min Sun Jeong, Presenter: Nothing to Disclose

Yun Sun Choi MD, PhD, Abstract Co-Author: Nothing to Disclose

Yun Jung Kim MD, Abstract Co-Author: Nothing to Disclose

Jin Su Kim, Abstract Co-Author: Nothing to Disclose

Ki Won Yang, Abstract Co-Author: Nothing to Disclose

Yoon Young Jung, Abstract Co-Author: Nothing to Disclose

Dae Jung Kim, Abstract Co-Author: Nothing to Disclose

To identify the patterns of injury in deltoid ligament after acute ankle sprain on MRI

Our study population was consisted of 24 patients (23 male, 1 female; mean age: 26 years) who had deltoid ligament injuries after acute ankle trauma. Ten patients underwent surgical repair of deltoid ligaments. The portion (superficial and deep), the severity (grade I, II, and III ) and the site (proximal, intermediate, and distal) of deltoid ligament injuries were analyzed on MR images. We also evaluated the presence of ankle fracture and the combined injuries including syndesmosis, lateral collateral ligament complex (LCLC), and posterior tibial tendon.

Superficial deltoid ligament injuries were seen in all 24 patients and 19 out of them (79.3%) had grade II and III injuries. Deep deltoid ligament injuries (grade II and III) were noted in 16 of the all patients (66.7%) who had superficial deltoid ligament injury. Five patients (5%) had intact deep deltoid ligaments. Half of all patients had complete tear of both superficial and deep deltoid ligaments. The most common sites of deltoid tear were proximal bony attachment (73.6%) of superficial deltoid ligament and distal insertion into the medial talus (75%) of deep deltoid ligament. Fourteen out of 24 patients had ankle fractures. Sixty six percent of the patients had combined injury of syndesmosis, and 54.2% of them had LCLC injury. Posterior tibial tendon tear was seen in 20.8%.

Superficial deltoid ligament injury was more frequent than deep deltoid ligament injury. The most common tear site of superficial deltoid was the tibial bony attachment of the ligament, while deep deltoid was near its medial talar insertion. The injuries of syndesmosis or LCLC were combined in more than half of the patients.

MRI can demonstrate the injury pattern of deltoid ligament with the associated injuries of bone and soft tissue, therefore it is useful for deciding on an appropriate treatment plan.

Jeong, M, Choi, Y, Kim, Y, Kim, J, Yang, K, Jung, Y, Kim, D, Which Deltoid Ligaments Are Interrupted in Acute Ankle Sprain?.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12026730.html