![]() ![]() The authors retrospectively studied the clinical and radiological outcomes of operative treatment of ankle fractures with DL rupture between March 2009 and December 2015. The current study was approved by the research board in our hospital. Thus, we retrospectively studied the ankle fracture patients with DL rupture in our center to evaluate the need for surgical repair of the deltoid ligament. Until now, the dilemma of whether the deltoid ligament should be surgically repaired in acute ankle fracture is still controversial. Johnson and Hill reported 30 patients with combined fibular fracture and deltoid ligament rupture, where the fibula was fixed and the deltoid ligament was left unrepaired, and the results showed poor symptomatic and functional result in 41% of patients. However, another study reported that unrepaired deltoid ligament may be a source of persistent pain or pronation deformity when not appropriately treated. A prospective randomized study reported no difference in early mobilization or in long term results between deltoid ligament repaired and unrepaired groups. However, in ankle fractures combined with DL rupture, the necessity of surgical repair of the deltoid ligament is always in debate.Įarly studies suggested that exploration of the medial side of the ankle and repair of the deltoid ligament were not necessary after anatomical reduction and rigid internal fixation of the lateral malleolus. Another magnetic resonance imaging investigation reported 58.3% of acute ankle fractures have been found with tears of the deltoid ligament. An arthroscopic study reported a partial or total rupture of the deltoid ligament in 39.6% of ankle fracture patients. The deltoid ligament (DL) rupture is highly relevant in clinical practice where ankle injuries are commonly encountered. Surgical repair of the DL is helpful in decreasing the postoperative MCS and malreduction rate, especially for the AO/OTA type-C ankle fractures. No significant difference was found between the AO/OTA type-B fracture with or without DL repair. In this type of injury, surgical repair of the DL can significantly decrease the malreduction rate ( P<0.05). AO/OTA type-C ankle fractures showed a positive correlation with malreduction (OR = 4.38, P = 0.03). Surgical repair of DL can significantly decrease the postoperative MCS ( P<0.05), and can also decrease the malreduction rate ( P<0.05). During followup, 14.9% (11/74) cases were found to be malreduced (MCS>5 mm), and 5.4% (4/74) went on to failure. According to the radiological malreduction of MCS, the odds ratio (OR) and 95% confidence interval (CI) for each potential relative factor were calculated. The pre- and post-operative medial clear space (MCS) were measured and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) were used for functional evaluation. ![]() Twenty patients were treated with surgical repair of the DL, while 54 were not. Methodsīetween 20, Seventy-four ankle fractures with DL rupture were identified and followed. The objective of the current study is to compare the outcomes of surgical treatment of ankle fracture with or without DL repair. Deltoid ligament (DL) rupture is commonly seen in clinical practice however the need to explore and surgically repair it is still in debate. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |