[Results of conservative treatment of ligament lesions of children's ankle joint--a prospective study].

Abstract

There is disagreement in the literature about the ideal treatment of ligamentous injuries of the ankle in children. We examined the results of controlled conservative treatment by means of a prospective study in 28 children, each with a fresh ligamentous ankle injury. In all patients the supinatory talus tilt was between 7 and 15 degrees as compared with the noninjured side. The children were treated with a plaster cast for 6 weeks. The results of the present study were compared with results of two other earlier investigations from our department. In one group the patients had been treated not uniformly conservatively for 1-5 weeks. In another group, patients were treated by operative ligamentous repair (5, 8). At the follow-up examination 82% of the children of the present study showed ligamentous stability, which is approximately the same percentage as it was found in operatively treated children (84%), but lies significantly higher than in inconsequentially conservatively treated patients (74%), (p greater than 0.05). 50% of the children in the present study complained about some discomfort, a number that is significantly higher than that found after operative treatment (30%), (p greater than 0.05). We assume that conservative treatment of fibular ankle lesions is justified in children with supinatory talus tilts between 7-15 degrees as compared with the noninjured side. Ligamentous stability can be expected in 80% of the patients.