scholarly journals Management of deltoid ligament injuries in acute ankle fracture: a systematic review

2022 ◽  
Vol 65 (1) ◽  
pp. E9-E15
Author(s):  
Michael James ◽  
Andrew Dodd
Keyword(s):  
Systematic Review ◽  
Ankle Fracture ◽  
Deltoid Ligament ◽  
Ligament Injuries

Adding deltoid ligament repair in ankle fracture treatment: Is it necessary? A systematic review

2019 ◽  
Vol 25 (6) ◽  
pp. 714-720 ◽  
Author(s):  
Sherif Dabash ◽  
Ahmed Elabd ◽  
Eric Potter ◽  
Isaac Fernandez ◽  
Chris Gerzina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ankle Fracture ◽  
Deltoid Ligament ◽  
Fracture Treatment ◽  
Ligament Repair

scholarly journals A systematic review of the measurement properties of patient reported outcome measures used for adults with an ankle fracture

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Rebecca McKeown ◽  
David R. Ellard ◽  
Abdul-Rasheed Rabiu ◽  
Eleni Karasouli ◽  
Rebecca S. Kearney
Keyword(s):  
Systematic Review ◽  
Construct Validity ◽  
Outcome Measures ◽  
Ankle Fracture ◽  
Methodological Quality ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Properties ◽  
Health Measurement ◽  
Patient Reported

Abstract Background Ankle fractures are painful and debilitating injuries that pose a significant burden to society and healthcare systems. Patient reported outcome measures (PROMs) are commonly used outcome measures in clinical trials of interventions for ankle fracture but there is little evidence on their validity and reliability. This systematic review aims to identify and appraise evidence for the measurement properties of ankle specific PROMs used in adults with an ankle fracture using Consensus Based Standards for the Selection of Health Measurement Instrument (COSMIN) methodology. Methods We searched MEDLINE, Embase and CINAHL online databases for evidence of measurement properties of ankle specific PROMs. Articles were included if they assessed or described the development of the PROM in adults with ankle fracture. Articles were ineligible if they used the PROM to assess the measurement properties of another instrument. Abstracts without full articles and conference proceedings were ineligible, as were articles that adapted the PROM under evaluation without any formal justification of the changes as part of a cross-cultural validation or translation process. Two reviewers completed the screening. To assess methodological quality we used COSMIN risk of bias checklist and summarised evidence using COSMIN quality criteria and a modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Two reviewers assessed the methodological quality and extracted the data for a sample of articles. Results The searches returned a total of 377 articles. From these, six articles were included after application of eligibility criteria. These articles evaluated three PROMs: A-FORM, OMAS and AAOS. The A-FORM had evidence of a robust development process within the patient population, however lacks post-formulation testing. The OMAS showed sufficient levels of reliability, internal consistency and construct validity. The AAOS showed low quality evidence of sufficient construct validity. Conclusions There is insufficient evidence to support the recommendation of a particular PROM for use in adult ankle fracture research based on COSMIN methodology. Further validation of these outcome measures is required in order to ensure PROMs used in this area are sufficiently valid and reliable to assess treatment effects. This would enable high quality, evidenced-based management of adults with ankle fracture.

Deltoid Ligament Injuries

2012 ◽  
pp. 78-78
Author(s):  
Augusto Sarmiento
Keyword(s):  
Deltoid Ligament ◽  
Ligament Injuries

Lunate fractures and associated radiocarpal and midcarpal instabilities: a systematic review

2017 ◽  
Vol 43 (1) ◽  
pp. 84-92 ◽  
Author(s):  
Meenalochani Shunmugam ◽  
Joideep Phadnis ◽  
Amy Watts ◽  
Gregory I. Bain
Keyword(s):  
Systematic Review ◽  
Shear Fracture ◽  
Ligament Injuries ◽  
Ulnar Styloid ◽  
Cast Immobilization ◽  
Coronal Image ◽  
Sagittal Image ◽  
Fracture Dislocations ◽  
Complex Injuries

The aim of this study was to analyse lunate fractures and any associated osseo-ligamentous injuries. A systematic review identified 34 cases. We identified carpal instabilities at the radiocarpal and midcarpal joints in volar and dorsal directions. Radiocarpal instabilities (10/34) were usually dorsoradial (8/10), with a transverse lunate fracture, best seen on a coronal image. Midcarpal instabilities (24/34) were usually volar (14/18), with a volar lunate shear fracture, best seen on a sagittal image. Instabilities were sub-classified into non-displaced, subluxated and dislocated. Associated fractures of the scaphoid and the radial and ulnar styloid processes were common. Lunate fractures without subluxation or dislocation had good outcomes with cast immobilization or fixation of associated fractures. Lunate fracture-subluxations are unstable injuries that are best managed with fixation of the carpal fractures. Lunate fracture-dislocations are complex injuries, requiring stabilization of the lunate, associated fractures and ligament injuries; complications are common and acute or delayed salvage procedures may be required.

Variability in the Reporting Terminology of Adverse Events and Complications in Ankle Fracture Fixation: A Systematic Review

2019 ◽  
Vol 41 (2) ◽  
pp. 170-176
Author(s):  
Stefan A. St George ◽  
Hooman Sadr ◽  
Chayanin Angthong ◽  
Murray Penner ◽  
Peter Salat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Fracture Fixation ◽  
Ankle Fracture ◽  
Soft Tissue Injuries ◽  
Classification Systems ◽  
Level Of Evidence ◽  
Implant Complications ◽  
Frequency Of Use ◽  
Standardized Reporting

Background: Classification systems for the reporting of surgical complications have been developed and adapted for many surgical subspecialties. The purpose of this systematic review was to examine the variability and frequency of reporting terms used to describe adverse events and complications in ankle fracture fixation. We hypothesized that the terminology used would be highly variable and inconsistent, corroborating previous results that have suggested a need for standardized reporting terminology in orthopedics. Methods: Ankle fracture outcome studies meeting predetermined inclusion and exclusion criteria were selected for analysis by 2 independent observers. Terms used to define adverse events and complications were identified and recorded. Discrepancies were resolved by consensus with the aid of a third observer. All terms were then compiled and assessed for variability and frequency of use throughout the studies involved. Reporting terminology was subsequently grouped into 10 categories. Results: In the 48 studies analyzed, 301 distinct terms were utilized to describe complications or adverse events. Of these terms, 74.4% (224/301) were found in a single study each. Only 1 term, “infection,” was present in 50% of studies, and only 19 of 301 terms (6.3%) were used in at least 10% of papers. The category that was most frequently reported was “infection,” with 89.6% of studies reporting on this type of adverse event using 25 distinct terms. Other categories were “wound healing complications” (72.9% of papers, 38 terms), “bone/joint complications” (66.7% of papers, 35 terms), “hardware/implant complications” (56.3% of papers, 47 terms), “revision” (56.3% of papers, 35 terms), “cartilage/soft tissue injuries” (45.8% of papers, 31 terms), “reduction/alignment issues” (45.8% of papers, 29 terms), “medical complications” (43.8% of papers, 32 terms), “pain” (29.2% of papers, 16 terms), and “other complications” (20.8% of papers, 13 terms). There was a 78.6% interobserver agreement in the identification of terms across the 48 studies included. Conclusion: The reporting terminology utilized to describe complications and adverse events in ankle fracture fixation was found to be highly variable and inconsistent. This variability prevents accurate reporting of complications and adverse events and makes the analysis of potential outcomes difficult. The development of standardized reporting terminology in orthopedics would be instrumental in addressing these challenges and allow for more accurate and consistent outcome reporting. Level of Evidence: Level III; systematic review of Level III studies and above.

Prevention of anterior cruciate ligament injuries in sports—Part I: Systematic review of risk factors in male athletes

2013 ◽  
Vol 22 (1) ◽  
pp. 3-15 ◽  
Author(s):  
Eduard Alentorn-Geli ◽  
Jurdan Mendiguchía ◽  
Kristian Samuelsson ◽  
Volker Musahl ◽  
Jon Karlsson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Ligament Injuries ◽  
Male Athletes ◽  
Anterior Cruciate Ligament Injuries ◽  
Anterior Cruciate

Short-Term Results of a Ruptured Deltoid Ligament Repair During an Acute Ankle Fracture Fixation

2017 ◽  
Vol 39 (1) ◽  
pp. 35-45 ◽  
Author(s):  
Seung Hun Woo ◽  
Su-Young Bae ◽  
Hyung-Jin Chung
Keyword(s):  
Clinical Outcomes ◽  
Fracture Fixation ◽  
Ankle Fracture ◽  
Linear Regression Analysis ◽  
Case Series ◽  
Deltoid Ligament ◽  
Radiographic Findings ◽  
Group 2 ◽  
Repair Group

Background: There is no consensus on the optimal treatment or preferred method of operation for the management of acute deltoid ligament injuries during an ankle fracture fixation. This study aimed to analyze the outcomes of repairing the deltoid ligament during the fixation of an ankle fracture compared to conservative management. Methods: We retrospectively evaluated 78 consecutive cases of a ruptured deltoid ligament with an associated ankle fracture between 2001 and 2016. All of the ankle fractures were treated with a plate and screw fixation. Patients in the conservative treatment for ruptured deltoid ligament underwent management from 2001 to 2008 (37 fractures, group 1), while the operative treatment for ruptured deltoid ligament was included from 2009 to 2016 (41 fractures, group 2). The outcome measures included radiographic findings, the American Orthopaedic Foot & Ankle Society ankle-hindfoot scores, visual analog scale scores, and the Foot Function Index. All patients were followed for an average of 17 months. Results: Radiologic findings in both groups were comparable, but the final follow-up of the medial clear space (MCS) was significantly smaller in the group 2 ( P < .01). Clinical outcomes were similar between the two groups ( P > .05). Comparing those who underwent syndesmotic fixation between both groups, group 2 showed a significantly smaller final follow-up MCS, and all clinical outcomes were better in group 2 ( P < .05). Linear regression analysis showed that the final follow-up MCS had a significant influence on clinical outcomes ( P < .05). Conclusion: Although the clinical outcomes were not significantly different between the 2 groups, we obtained a more favorable final follow-up MCS in the deltoid repair group. Particularly when accompanied by a syndesmotic injury, the final follow-up MCS and the clinical outcomes were better in the deltoid repair group. In the case of high-grade unstable fractures of the ankle with syndesmotic instability, a direct repair of the deltoid ligament was adequate for restoring medial stability. Level of Evidence: Level III, retrospective comparative case series.

Arthroscopic Findings in Patients with Chronic Ankle Instability

2002 ◽  
Vol 30 (3) ◽  
pp. 402-409 ◽  
Author(s):  
Beat Hintermann ◽  
Andreas Boss ◽  
Dirk Schäfer
Keyword(s):  
Structural Changes ◽  
Ankle Instability ◽  
Cartilage Damage ◽  
Case Series ◽  
Chronic Ankle Instability ◽  
Ankle Arthroscopy ◽  
Lateral Ligament ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Ligament Injuries

Background There are little objective data on structural changes of the chronically unstable ankle. Such knowledge could help with preoperative planning. Hypothesis Preoperative ankle arthroscopy provides important insights into the causes and mechanisms of ankle instability and the resulting disability. Study Design Case series. Methods From 1993 to 1999, arthroscopic examination was performed in the ankles of 148 patients with symptomatic chronic ankle instability that had lasted 6 months or more. All structural changes were recorded and compared with the clinical diagnosis. Results A rupture or elongation of the anterior talofibular ligament was noted in 86% of ankles, of the calcaneofibular ligament in 64%, and of the deltoid ligament in 40%. Cartilage damage was noted in 66% of ankles with lateral ligament injuries, whereas 98% of the ankles with deltoid ligament injuries had cartilage damage. Although lateral instability could be verified arthroscopically in 127 patients, medial instability was presumed clinically in 38 patients but was actually detected in 54 patients arthroscopically. Conclusion Preoperative ankle arthroscopy revealed an essential amount of information that would otherwise have been undetected. For instance, the ligaments showed typical abnormalities corresponding to different entities of ankle instability and different intra-articular pathologic conditions.

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