Rupture of the lateral ligaments of the ankle: operation or plaster cast? A propective study

The material comprises 444 patients, aged 12-50 years, with acute sprain of the ankle, seen over an 11-month period (1.10. 1977 to 31.8. 1978). Clinical examination showed no rupture of the ligaments in 53. Arthrography in the remaining patients revealed rupture of the lateral ligaments in 209 (in two-thirds of the anterior talofibular ligament and in one-third of the anterior talofibular as well as calcaneofibular ligament). Conservative treatment with a below-knee plaster cast for 5 weeks was employed in 107 patients, while 102 were treated surgically by suture of the ruptured ligament(s) and subsequently wore a below-knee plaster cast for 5 weeks. The follow-up 1 year after the accident was attended by 63 per cent of the patients. Good results were found in 76 per cent of those treated by plaster cast only and in 81 per cent of those treated by surgery. The difference is not statistically significant.