Association of medial talar chondral lesions with deltoid ligament ruptures in ankle fractures: a multicenter study of 100 cases.

Sakaki, Marcos Hideyo; Bergamasco, Jordanna Maria Pereira; Albino, Rômulo Ballarin; Nishikawa, Danilo Ryuko Candido · Eur J Orthop Surg Traumatol · 2026

cross_sectional · Level IV

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Abstract

This study aimed to investigate the incidence of medial talar chondral lesions in ankle fractures associated with deltoid ligament ruptures and to evaluate their correlation with fracture-related characteristics, which could support open deltoid ligament repair during fracture fixation. A retrospective, cross-sectional and multicenter study that included 100 patients with deltoid ligament rupture in the context of ankle fracture. All data related to the chondral lesions and ankle fracture were obtained during the preoperative and intraoperative periods. Medial cartilage lesions of the talar dome were identified in 43 patients (43%) with deltoid ligament ruptures. The mean lesion area was 25 mm<sup>2</sup>. All cases with intra-articular loose bodies were associated with chondral injuries, representing 13% of the overall cohort and 30% of patients with chondral lesions. The only significant correlation identified was between the presence of the medial talar chondral lesions and posterior malleolar fractures (p = 0.04). This study identified a 43% incidence of medial talar chondral lesions in ankle fractures associated with deltoid ligament rupture, highlighting a high frequency of associated medial talar chondral lesions, which may represent an additional factor to consider when evaluating the role of deltoid ligament repair in this clinical setting. IV, cross-sectional study.