scholarly journals Deltoid Ligament Injuries Associated with Ankle Fractures—Argument for Repair of the Deltoid Ligament

2020 ◽  
Vol 7 (1) ◽  
pp. 5-7
Author(s):  
Vinod K Panchbhavi
Keyword(s):  
Ankle Fractures ◽  
Deltoid Ligament ◽  
Ligament Injuries

Deltoid Ligament Injuries Associated With Ankle Fractures: Arguments For and Against Direct Repair

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jesse F. Doty ◽  
Burton D. Dunlap ◽  
Vinod K. Panchbhavi ◽  
Michael J. Gardner
Keyword(s):  
Ankle Fractures ◽  
Deltoid Ligament ◽  
Ligament Injuries ◽  
Direct Repair

scholarly journals An update on the work-up and management of ankle fractures: A literature review

Medwave ◽  
2021 ◽  
Vol 21 (02) ◽  
pp. e8130-e8130
Author(s):  
Pablo Ruiz ◽  
Jorge Filippi
Keyword(s):  
Literature Review ◽  
Ankle Fractures ◽  
Deltoid Ligament ◽  
Ligament Injuries ◽  
Axial Tomography ◽  
Malleolar Fractures ◽  
Posterior Malleolus ◽  
Computerized Axial Tomography ◽  
Work Up ◽  
Radiological Studies

Our understanding of the management of ankle fractures has significantly improved in recent years. Computerized axial tomography and better biomechanical insights have renewed the underlying concepts for both diagnosis and treatment. Notwithstanding, some aspects of the management of malleolar fractures still lack consensus. This review aims to update concepts on the study and management of ankle fractures. Stability, radiological studies, computerized axial tomography, management of associated ligament injuries (deltoid ligament and syndesmosis), and posterior malleolus fractures are covered in the article. The authors’ opinions and the evidence are discussed for each question.

scholarly journals Whether need to repair deltoid ligament injuries in Supination-external Rotation type Ⅳ ankle fractures

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0052
Author(s):  
Yunfeng Yang
Keyword(s):  
Scoring System ◽  
External Rotation ◽  
Ankle Fractures ◽  
Ligament Injury ◽  
Deltoid Ligament ◽  
Ligament Injuries ◽  
Clear Space ◽  
Significant Difference ◽  
Supination External Rotation

Category: Ankle Introduction/Purpose: To evaluate the effect of repairing deltoid ligament in patients with supination-external rotation type? ankle fractures. Methods: Between January 2013 and June 2016, 35 patients of supination-external rotation type? ankle fractures associated with deltoid ligament injury had complete medical records and were included in this study. Among all, 30 cases involved pure deltoid ligament injuries while others also included medial malleolus fractures. All fractures were treated by open reduction and internal fixation. Patients were assigned to the repaired group (21 patients) or the non-repaired group (14 patients) according to whether deltoid ligament injuries were treated during the surgery. No significant difference was found in gender, age, injury pattern, time from injury to operation(P>0.05), which was comparable. Medial clear space, visual analogue scale(VAS) score, and American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score(6 months, one year, two years after surgery), Baird-Jackson scoring system and complications were recorded. Results: Thirty-five patients were followed up 21-28months.The mean duration of operation in the repaired group was significantly longer than that of the non-repaired group.Baird-Jackson scoring system: the excellent rate of the repaired group was 90.5% while the non-repaired group was 85.7% . The VAS scores and the medial clear space of preoperative and final follow-up were significantly improved. At the last follow-up,2.85 percent of the patients presented with ankle instability while 8.5 percent of them occured traumatic arthritis. The AOFAS scores at 6, 12, and 24 months after operation were (82.1 ± 6.6; 86.2 ± 5.9; 91.5 ± 5.8) and (78.1 ± 6.5; 83.9 ± 5.6; 90.3 ± 5.6). However, none of them showed significant difference between the two groups (P>0.05). Conclusion: It’s unnecessary to repair the deltoid ligament in patients with supination-external rotation type? ankle fractures when ankle mortise restores after the fractures are fixed.

scholarly journals Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Bohua Li ◽  
Shanxi Wang ◽  
Zhengdong Zhang ◽  
Hai Yang ◽  
Jun Li ◽  
...  
Keyword(s):  
External Fixation ◽  
Short Form ◽  
Ankle Fractures ◽  
Deltoid Ligament ◽  
Functional Evaluation ◽  
Ligament Repair ◽  
Fracture Union ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background The topic that whether the injured deltoid ligament should be repaired when associated with ankle joint fractures is still discussed. The objective of this study was to compare the clinical effect of open reduction and internal fixation (ORIF) with deltoid ligament repair (DLR) or transarticular external fixation (TEF) in treating supination-external rotation type IV (SER IV) ankle fractures. Methods Between January 2012 and December 2015, 43 patients were diagnosed as SER IV ankle fractures, 20 underwent ORIF and transarticular external fixation (TEF) without DLR (group 1), 23 were treated with ORIF and DLR (group 2). The pre- and post-operative radiographic examination were performed, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the visual analog scale (VAS), the Medical Outcomes Short Form 36-item questionnaire score (SF-36), and the ankle range of motion (ROM) were used for functional evaluation. Results In both groups, the three scores improved significantly after surgery, but there was no significant difference between the two groups. At 6 weeks after surgery, patients in group 2 had better ankle ROM than group 1 (29.35 ± 2.033 vs. 40.35 ± 3.550, P <  0.001), but there was no difference at 12 months postoperatively. No cases of bone nonunion or post-traumatic arthritic changes were seen during the follow-up. Patients in group 1 required a shorter time to achieve fracture union than patients in group 2. Conclusions ORIF with TIF is an optional strategy to manage SER IV ankle fractures as it achieves comparable functional results to ORIF with DLR. It also allows patients to start relatively earlier weight-bearing and may promote fracture union.

Correlating Arthroscopic and Radiographic Findings of Deep Deltoid Ligament Injuries in Rotational Ankle Fractures

2020 ◽  
pp. 107110072096279
Author(s):  
D’Ann Arthur ◽  
Casey Pyle ◽  
Stephen J. Shymon ◽  
David Lee ◽  
Thomas Harris
Keyword(s):  
External Rotation ◽  
Open Reduction Internal Fixation ◽  
Ankle Fractures ◽  
Ligament Injury ◽  
Deltoid Ligament ◽  
Posterior Tibial Tendon ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Type Iv ◽  
Retrospective Comparative Study

Background: The deep deltoid ligament (DDL) is a key stabilizer to the medial ankle and ankle mortise and can be disrupted in ligamentous supination external rotation type IV (LSER4) ankle fractures. The purpose of this study was to define the medial clear space (MCS) measurement on injury mortise radiographs that corresponds with complete DDL injury. Methods: A retrospective record review at a level 1 hospital was performed identifying patients with LSER4 ankle fractures who underwent arthroscopy and open reduction internal fixation. Chart reviews provided arthroscopic images and operative reports. Complete DDL injury was defined as arthroscopic visualization of the posterior tibial tendon (PTT). Inability to completely visualize the PTT was defined as a partial DDL injury. MCS was measured on injury mortise radiographs. Eighteen subjects met inclusion criteria. Results: Twelve subjects had complete and 6 subjects had partial DDL injury based on arthroscopic findings. Patients with complete DDL injury and those with partial DDL injury had injury radiograph MCS ranging from 5.5 to 29.9 mm and 4.0 to 5.0 mm, respectively. All patients with MCS ≥5.5 mm on injury radiographs had complete DDL injury and all patients with MCS ≤5.0 mm on injury radiographs had partial DDL injury. Conclusion: Complete DDL injury was found on injury ankle mortise radiographs as MCS widening of ≥5.5 mm, which correlated with arthroscopic visualization of the PTT. Using this cutoff, surgeons can surmise the presence of a complete deltoid ligament injury, allowing for improved preoperative planning. Level of Evidence: Level III, retrospective comparative study.

Acute Deltoid Ligament Repair in Ankle Fractures

2020 ◽  
Vol 25 (4) ◽  
pp. 597-612
Author(s):  
Gonzalo F. Bastias ◽  
Jorge Filippi
Keyword(s):  
Ankle Fractures ◽  
Deltoid Ligament ◽  
Ligament Repair
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