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

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) o...

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Main Authors: Bohua Li, Shanxi Wang, Zhengdong Zhang, Hai Yang, Jun Li, Qin Li, Lei Liu
Format: Article
Language:English
Published: BMC 2019-10-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-019-2840-5
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author Bohua Li
Shanxi Wang
Zhengdong Zhang
Hai Yang
Jun Li
Qin Li
Lei Liu
author_facet Bohua Li
Shanxi Wang
Zhengdong Zhang
Hai Yang
Jun Li
Qin Li
Lei Liu
author_sort Bohua Li
collection DOAJ
description 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.
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spelling doaj.art-4bb88c9bddc4461bbce52b2514700e742022-12-21T19:19:05ZengBMCBMC Musculoskeletal Disorders1471-24742019-10-012011710.1186/s12891-019-2840-5Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative studyBohua Li0Shanxi Wang1Zhengdong Zhang2Hai Yang3Jun Li4Qin Li5Lei Liu6Department of Orthopedics, The First Hospital of Lanzhou UniversityDepartment of Orthopedics, West China Hospital, Sichuan UniversityDepartment of Orthopedics, West China Hospital, Sichuan UniversityDepartment of Orthopedics, West China Hospital, Sichuan UniversityDepartment of Orthopedics, West China Hospital, Sichuan UniversityDepartment of Orthopedics, West China Hospital, Sichuan UniversityDepartment of Orthopedics, West China Hospital, Sichuan UniversityAbstract 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.http://link.springer.com/article/10.1186/s12891-019-2840-5Transarticular external fixationORIFDeltoid ligament repairSupination-external rotationAnkle fracture
spellingShingle Bohua Li
Shanxi Wang
Zhengdong Zhang
Hai Yang
Jun Li
Qin Li
Lei Liu
Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study
BMC Musculoskeletal Disorders
Transarticular external fixation
ORIF
Deltoid ligament repair
Supination-external rotation
Ankle fracture
title Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study
title_full Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study
title_fullStr Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study
title_full_unstemmed Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study
title_short Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study
title_sort transarticular external fixation versus deltoid ligament repair in treating ser iv ankle fractures a comparative study
topic Transarticular external fixation
ORIF
Deltoid ligament repair
Supination-external rotation
Ankle fracture
url http://link.springer.com/article/10.1186/s12891-019-2840-5
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