Surgical Repair And Unrepair Treatment Of Deltoid Ligament Injury Associated With Ankle Fracture:A Meta-analysis

Background:In this study,through the meta analysis of the clinical efficacy of surgical treatment and conservative treatment of triangular ligament injury associated with ankle fracture,we evaluated the two treatment schemes of surgical treatment and conservative treatment,and which one was used to treat deltoid ligament injury.It is more favorable for the prognosis recovery of the patients,thus providing a more sufficient basis for the clinical treatment of triangular ligament injury associated with ankle fracture and the selection of the best treatment scheme.Objective:In order to evaluate the difference of clinical prognosis between surgical treatment and conservative treatment of the loss of triangular ligament by meta analysis of the surgical treatment and conservative treatment of triangular ligament injury associated with ankle fracture.Therefore,it provides a more adequate treatment for ankle fracture associated with loss of triangular ligament in the selection of treatment plan.Methods: "Deltoid ligament injury","ankle fracture","treatment" as the Chinese and foreign key words,“deltoid ligament injury”,“ankle joint fracture”,"Surgical treatment","Conservative treatment" as the English key words,using Wanfang,Weipu,To search all the published literatures about surgical repair and conservative treatment of ankle fracture combined with deltoid ligament rupture in Pubmed database.All the retrieved documents were screened.The postoperative AOFAS score,postoperative complications,medial ankle space(MDS)and talus inclination were selected to evaluate the clinical efficacy of the patients.The relevant data were extracted from the literature that finally met the standard,and the data were entered into the revman 5.3 statistical software for meta-analysis.Results:Finally,12 articles were included,9 were in Chinese and 3 in English.A total of 770 patients with rupture of the triangular ligament with ankle fracture were included(373patients in the surgical treatment group and 397 patients in the conservative treatment group).The results of meta analysis in the surgical repair group were higher than those in the conservative treatment group.The results of comparison of the excellent and good rate of aofas score after operation were as follows:(OR=4.17,95%CI=2.32,7.50,Z=4.78,p<0.01).The incidence of postoperative complications was analyzed as follows:(OR=0.19,95%CI=0.1,0.34,Z=5.33,p<0.01).The comparison of operation time between surgical repair group and conservative treatment group was as follows:(WMD=20.76,95%CI=15.49,23.02,Z=17.96,p<0.01).The talus inclination in the surgical group compared with the conservative treatment group was that(MD=-2.59,95%CI=-4.14,-1.03,P<0.01).The Medial space of ankle joint in the surgical group compared with the conservative treatment group was that(WMD=-0.59,95%CI=-0.78,-0.37,P<0.01).The postoperative visual analogue score(VAS)in the surgical group compared with the conservative treatment group was that(WMD=-1.64,95%CI=-1.73,-1.55,P<0.01)Conclusion:Comparison between surgical treatment and conservative treatment of deltoid ligament injury,The former had higher AOFAS score after operation,lower visual analogue score,longer operation time,less postoperative complications,lower medial ankle space and talus inclination.