PURPOSE The indications of deltoid ligament repair in ankle injuries with widened medial clear space in the absence of medial malleolus fracture remain controversial. Many authors reported no difference in long-term functional outcomes, while others stated that persistent medial clear space widening and malreduction are higher when deltoid ligaments went without repair. This meta-analysis aims to report the current published evidence about the outcomes of deltoid ligament repair in ankle fractures. METHODS Several databases were searched through May 2018 for comparative studies. The primary outcome was the medial clear space correction, while secondary outcomes included maintenance of medial clear space reduction, pain scores, functional outcome, and total complications if any. Three comparative studies met the inclusion criteria for the meta-analysis. The analysis included a total of 192 patients, 81 in the deltoid ligament repair group and 111 in the non-repair group. RESULTS The medial clear space correction and maintenance of the said correction on final follow-up radiographs were superior in the deltoid ligament repair group. Although the pain scores were better in the repair group at the final follow-up, this did not result in a better functional outcome, with similar total complication rates. CONCLUSION In conclusion, those who had their deltoid ligament repaired had superior early and late radiological correction of the medial clear space, an indicator of the quality of ankle reduction with better pain scores. However, no differences in the functional outcome and complications rate were reported.

中文翻译：

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急性踝关节骨折初级三角韧带修复的结果：比较研究的荟萃分析。


目的 在没有内踝骨折的情况下，对于伴有内侧间隙扩大的踝关节损伤，三角韧带修复的适应症仍然存在争议。许多作者报告说，长期功能结果没有差异，而其他人则表示，当三角韧带未修复时，持续的内侧间隙扩大和复位不良会更高。本荟萃分析旨在报告当前发表的有关踝关节骨折三角韧带修复结果的证据。方法 检索了截至 2018 年 5 月的多个数据库以进行比较研究。主要结果是内侧间隙矫正，次要结果包括维持内侧间隙减少、疼痛评分、功能结果和总并发症（如果有）。三项比较研究符合荟萃分析的纳入标准。该分析总共包括 192 名患者，其中三角韧带修复组 81 名，非修复组 111 名。结果三角韧带修复组的内侧间隙矫正和最终随访X光片上所述矫正的维持均优于三角韧带修复组。尽管在最终随访时修复组的疼痛评分更好，但这并没有带来更好的功能结果，总并发症发生率相似。结论 总之，三角韧带修复的患者对内侧间隙的早期和晚期放射学矫正效果更好，这是踝关节复位质量的一个指标，具有更好的疼痛评分。然而，功能结果和并发症发生率没有报告差异。