Adding deltoid ligament repair in ankle fracture treatment: Is it necessary? A systematic review
•The most common mechanisms of injury to deltoid ligament are pronation-abduction, pronation-external rotation (PER), and supination-external rotation (SER).•Controversy surrounds the treatment of DL rupture in literature.•The purpose of this article is to review the literature of DL repair and esta...
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| Published in | Foot and ankle surgery Vol. 25; no. 6; pp. 714 - 720 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
France
Elsevier Ltd
01.12.2019
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| Subjects | |
| Online Access | Get full text |
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| Abstract | •The most common mechanisms of injury to deltoid ligament are pronation-abduction, pronation-external rotation (PER), and supination-external rotation (SER).•Controversy surrounds the treatment of DL rupture in literature.•The purpose of this article is to review the literature of DL repair and establish a clear indication for operative intervention.
Deltoid ligament injuries are typically caused by supination-external rotation or pronation injury. Numerous ligament reconstruction techniques have been proposed; however, clear indications for operative repair have not yet been well established in the literature.
We reviewed primary research articles comparing ORIF treatment for ankle fracture with versus without deltoid ligament repair.
Five studies were identified with a total of 281 patients. 137 patients underwent ORIF with deltoid repair, while 144 patients underwent ORIF without deltoid ligament repair. Clinical, radiographic, and functional outcomes, as well as complications were considered. The average follow-up was 31 months (range, 5–120).
Current literature does not provide clear indication for repair of the deltoid ligament at the time of ankle fracture repair. There may be some advantages of adding deltoid ligament repair for patients with high fibular fractures or in patients with concomitant syndesmotic fixation.
Level of clinical evidence: III. |
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| AbstractList | •The most common mechanisms of injury to deltoid ligament are pronation-abduction, pronation-external rotation (PER), and supination-external rotation (SER).•Controversy surrounds the treatment of DL rupture in literature.•The purpose of this article is to review the literature of DL repair and establish a clear indication for operative intervention.
Deltoid ligament injuries are typically caused by supination-external rotation or pronation injury. Numerous ligament reconstruction techniques have been proposed; however, clear indications for operative repair have not yet been well established in the literature.
We reviewed primary research articles comparing ORIF treatment for ankle fracture with versus without deltoid ligament repair.
Five studies were identified with a total of 281 patients. 137 patients underwent ORIF with deltoid repair, while 144 patients underwent ORIF without deltoid ligament repair. Clinical, radiographic, and functional outcomes, as well as complications were considered. The average follow-up was 31 months (range, 5–120).
Current literature does not provide clear indication for repair of the deltoid ligament at the time of ankle fracture repair. There may be some advantages of adding deltoid ligament repair for patients with high fibular fractures or in patients with concomitant syndesmotic fixation.
Level of clinical evidence: III. Deltoid ligament injuries are typically caused by supination-external rotation or pronation injury. Numerous ligament reconstruction techniques have been proposed; however, clear indications for operative repair have not yet been well established in the literature. We reviewed primary research articles comparing ORIF treatment for ankle fracture with versus without deltoid ligament repair. Five studies were identified with a total of 281 patients. 137 patients underwent ORIF with deltoid repair, while 144 patients underwent ORIF without deltoid ligament repair. Clinical, radiographic, and functional outcomes, as well as complications were considered. The average follow-up was 31 months (range, 5-120). Current literature does not provide clear indication for repair of the deltoid ligament at the time of ankle fracture repair. There may be some advantages of adding deltoid ligament repair for patients with high fibular fractures or in patients with concomitant syndesmotic fixation. III. BACKGROUNDDeltoid ligament injuries are typically caused by supination-external rotation or pronation injury. Numerous ligament reconstruction techniques have been proposed; however, clear indications for operative repair have not yet been well established in the literature. METHODSWe reviewed primary research articles comparing ORIF treatment for ankle fracture with versus without deltoid ligament repair. RESULTSFive studies were identified with a total of 281 patients. 137 patients underwent ORIF with deltoid repair, while 144 patients underwent ORIF without deltoid ligament repair. Clinical, radiographic, and functional outcomes, as well as complications were considered. The average follow-up was 31 months (range, 5-120). CONCLUSIONSCurrent literature does not provide clear indication for repair of the deltoid ligament at the time of ankle fracture repair. There may be some advantages of adding deltoid ligament repair for patients with high fibular fractures or in patients with concomitant syndesmotic fixation. LEVEL OF CLINICAL EVIDENCEIII. |
| Author | Gerzina, Chris Potter, Eric Fernandez, Isaac Thabet, Ahmed M. Abdelgawad, Amr Dabash, Sherif Elabd, Ahmed McGarvey, William |
| Author_xml | – sequence: 1 givenname: Sherif orcidid: 0000-0001-8817-6390 surname: Dabash fullname: Dabash, Sherif email: sdabash@gmail.com, dabashs@hss.edu organization: Department of Orthopaedic Surgery, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, United States – sequence: 2 givenname: Ahmed orcidid: 0000-0002-6719-1134 surname: Elabd fullname: Elabd, Ahmed organization: Department of Orthopaedic Surgery & Rehabilitation, Texas Tech University Health Sciences Center — El Paso, 4801 Alberta Avenue, El Paso, TX, 79905 United States – sequence: 3 givenname: Eric orcidid: 0000-0003-0351-4472 surname: Potter fullname: Potter, Eric organization: Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center — El Paso, Medical Education Building 2200, 5001 El Paso Drive, El Paso, TX, 79905, United States – sequence: 4 givenname: Isaac surname: Fernandez fullname: Fernandez, Isaac organization: Department of Orthopaedic Surgery & Rehabilitation, Texas Tech University Health Sciences Center — El Paso, 4801 Alberta Avenue, El Paso, TX, 79905 United States – sequence: 5 givenname: Chris orcidid: 0000-0002-2185-5206 surname: Gerzina fullname: Gerzina, Chris organization: Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center — El Paso, Medical Education Building 2200, 5001 El Paso Drive, El Paso, TX, 79905, United States – sequence: 6 givenname: Ahmed M. surname: Thabet fullname: Thabet, Ahmed M. organization: Department of Orthopaedic Surgery & Rehabilitation, Texas Tech University Health Sciences Center — El Paso, 4801 Alberta Avenue, El Paso, TX, 79905 United States – sequence: 7 givenname: William surname: McGarvey fullname: McGarvey, William organization: Department of Orthopaedic Surgery, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, 77030, United States – sequence: 8 givenname: Amr orcidid: 0000-0003-0112-4147 surname: Abdelgawad fullname: Abdelgawad, Amr organization: Department of Orthopaedic Surgery & Rehabilitation, Texas Tech University Health Sciences Center — El Paso, 4801 Alberta Avenue, El Paso, TX, 79905 United States |
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| Copyright | 2018 European Foot and Ankle Society Copyright © 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved. |
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| Keywords | Deltoid ligament Deltoid ligament repair Medial collateral ligament ankle Ankle fracture Deltoid ligament reconstruction |
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| Snippet | •The most common mechanisms of injury to deltoid ligament are pronation-abduction, pronation-external rotation (PER), and supination-external rotation... Deltoid ligament injuries are typically caused by supination-external rotation or pronation injury. Numerous ligament reconstruction techniques have been... BACKGROUNDDeltoid ligament injuries are typically caused by supination-external rotation or pronation injury. Numerous ligament reconstruction techniques have... |
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| SubjectTerms | Ankle fracture Ankle Fractures - surgery Deltoid ligament Deltoid ligament reconstruction Deltoid ligament repair Fracture Fixation, Internal Humans Ligaments, Articular - injuries Ligaments, Articular - surgery Medial collateral ligament ankle Open Fracture Reduction Postoperative Complications Rupture - surgery |
| Title | Adding deltoid ligament repair in ankle fracture treatment: Is it necessary? A systematic review |
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