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. 2021 Oct;52(10):3156-3160.
doi: 10.1016/j.injury.2021.06.020. Epub 2021 Jun 30.

Deltoid ligament arthroscopic repair in ankle fractures: Case series

Nacime Salomão Barbachan Mansur  1 , Fernando Cepollina Raduan  2 , Andre Vitor Kerber Cavalcante Lemos  2 , Daniel Soares Baumfeld  3 , Gustavo Tadeu Sanchez  2 , Marcelo Pires do Prado  4 , Caio Augusto de Souza Nery  2
Affiliations

Deltoid ligament arthroscopic repair in ankle fractures: Case series

Nacime Salomão Barbachan Mansur et al. Injury. 2021 Oct.

Abstract

Introduction: Diagnosis and treatment of ankle medial ligament lesions in malleolar fractures has always been a matter of controversy. Even when deltoid involvement is clear, the direct repair of this structure is not a consensus. Recently, deltoid repair through an arthroscopic technique was described aiming to potentialize better clinical results and minimize complications.

Objective: Demonstrate safety and functional results on patients with ankle fractures submitted to open reduction and internal fixation and arthroscopic deltoid repair.

Methods: This is a retrospective study in patients diagnosed with ankle fractures associated with acute deltoid injuries submitted to open malleolar fixation and deltoid arthroscopic repair between June 2016 and January 2020. All patients were evaluated for pain and functionality according to the Visual Analogue Scale (VAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS) at a minimum of 6 months follow-up.

Results: From January 2016 to January 2020, 20 ankles with fractures or dislocations were operated and the deltoid ligament rupture was repaired arthroscopically. A mean follow-up of 14.45 months (6-48) was observed, and patients presented an average AOFAS of 93.5 (SD 7.25) and a VAS of 0.75 (SD 1.05). Three minor complications were noticed and no signs of medial chronic instability, loss of reduction or osteoarthritis were observed.

Discussion: The repair of the deltoid complex and the low morbidity of the arthroscopic technique used may improve the clinical outcomes of these patients. Additional studies, with a prospective and comparative methodology are required to sustain this proposal.

Design: Level IV. Retrospective case series.

Keywords: Ankle fractures; Ankle injuries; Arthroscopy; Deltoid; Joint Instability.

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Conflict of interest statement

Declaration of Competing Interests Caio Nery and Daniel Baumfeld are Consultors/Speakers for: Arthrex Inc and Gleistlich Biomaterials. Fernando Raduan and Marcelo Prado are Consultors/Speakers for: Arthrex Inc. The cited companies did not finance the study or participate in any phase of its conduction. Implants used at this study were from several companies since surgeries were performed at a public hospital. All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure and declare no support from any organization for the submitted work; Other authors have no financial relationships with any organizations that might have an interest in the submitted work in the previous ten years; no other relationships or activities that could appear to have influenced the submitted work.

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