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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

Surgical treatment of ankle fracture with or without deltoid ligament repair: a comparative study

Authors: Hong-Mou Zhao, Jun Lu, Feng Zhang, Xiao-Dong Wen, Yi Li, Ding-Jun Hao, Xiao-Jun Liang

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

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Abstract

Background

Deltoid ligament (DL) rupture is commonly seen in clinical practice; however the need to explore and surgically repair it is still in debate. The objective of the current study is to compare the outcomes of surgical treatment of ankle fracture with or without DL repair.

Methods

Between 2009 and 2015, Seventy-four ankle fractures with DL rupture were identified and followed. Twenty patients were treated with surgical repair of the DL, while 54 were not. 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. According to the radiological malreduction of MCS, the odds ratio (OR) and 95% confidence interval (CI) for each potential relative factor were calculated.

Results

The mean followup time was 53.7 months. The mean MCS preoperatively, postoperatively, and at last followup time were 8.7 ± 2.4 (range, 6.2–14.8) mm, 3.7 ± 0.9 (range, 2.6–6.4) mm, 3.6 ± 1.0 (range, 2.6–6.8) mm, respectively. The mean AOFAS score was 86.4 ± 8.1 (range, 52–100) points, and the mean VAS was 1.4 ± 1.4 (range, 0–7) points. During followup, 14.9% (11/74) cases were found to be malreduced (MCS>5 mm), and 5.4% (4/74) went on to failure. Surgical repair of DL can significantly decrease the postoperative MCS (P<0.05), and can also 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). In this type of injury, surgical repair of the DL can significantly decrease the malreduction rate (P<0.05). No significant difference was found between the AO/OTA type-B fracture with or without DL repair.

Conclusions

Surgical repair of the DL is helpful in decreasing the postoperative MCS and malreduction rate, especially for the AO/OTA type-C ankle fractures.
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Metadata
Title
Surgical treatment of ankle fracture with or without deltoid ligament repair: a comparative study
Authors
Hong-Mou Zhao
Jun Lu
Feng Zhang
Xiao-Dong Wen
Yi Li
Ding-Jun Hao
Xiao-Jun Liang
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1907-4

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