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...
Main Authors: | , , , , , , |
---|---|
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 |
_version_ | 1819014869091876864 |
---|---|
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. |
first_indexed | 2024-12-21T02:22:41Z |
format | Article |
id | doaj.art-4bb88c9bddc4461bbce52b2514700e74 |
institution | Directory Open Access Journal |
issn | 1471-2474 |
language | English |
last_indexed | 2024-12-21T02:22:41Z |
publishDate | 2019-10-01 |
publisher | BMC |
record_format | Article |
series | BMC Musculoskeletal Disorders |
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 |
work_keys_str_mv | AT bohuali transarticularexternalfixationversusdeltoidligamentrepairintreatingserivanklefracturesacomparativestudy AT shanxiwang transarticularexternalfixationversusdeltoidligamentrepairintreatingserivanklefracturesacomparativestudy AT zhengdongzhang transarticularexternalfixationversusdeltoidligamentrepairintreatingserivanklefracturesacomparativestudy AT haiyang transarticularexternalfixationversusdeltoidligamentrepairintreatingserivanklefracturesacomparativestudy AT junli transarticularexternalfixationversusdeltoidligamentrepairintreatingserivanklefracturesacomparativestudy AT qinli transarticularexternalfixationversusdeltoidligamentrepairintreatingserivanklefracturesacomparativestudy AT leiliu transarticularexternalfixationversusdeltoidligamentrepairintreatingserivanklefracturesacomparativestudy |