Elsewhere it is suggested that no uniform classification system exists for medial ligament injuries partly because they are uncommon and frequently occur combined with injuries of the lateral ligaments and or syndesmotic fractures. When it does occur patients experience a slight abduction of the ankle with each step and complain of pain on the medial side. Eversion stress X-rays may indicate some valgus instability of the ankle and widening of the mortice on the medial side. This may be due to non-union of a prior fibular fracture. MRI may be helpful correct diagnosis of this condition.
Conservative treatment is attempted first.
This involves taping, bracing, casting, physiotherapy, and orthoses. If unsuccessful, the deltoid ligament is sutured. If it is not possible to do this then a graft must be used. This involves taking part of a suitable tendon e.g. tibialis posterior, routing it through the medial malleolus and stitching it back on itself. Fractures of the Distal Part of the Fibula with Associated Disruption of the Deltoid Ligament - Treatment without Repair of the Deltoid Ligament.