Osteochondral involvement in fibulotalar ligament ruptures

Whereas controversial opinions exist as to whether operative or conservative functional therapy should be done in patients with rupture of the ligaments of the upper ankle, operative therapy of the rupture with osteochondral fragments is accepted. We, therefore investigated 130 cases with radiological signs of ligamental rupture or rupture with osteochondral fragments we had operated on since 1980. In 37 per cent of these children we found intraoperatively an osteochondral fragment; one-third of these could not be seen on x-ray film. Our conclusion is that operative treatment is indicated in typical radiologic signs of rupture of the ligaments of the upper ankle in children.