AI Article Synopsis
- The systematic review analyzed diagnostic strategies for acute deltoid ligament injuries related to ankle fractures, as existing surgical outcomes have shown no convincing improvement.
- A search of databases revealed 31 studies, mainly relying on radiologic findings for treatment decisions, notably using stressed radiographs to assess injuries.
- The review highlights a lack of standardized diagnostic methods across the studies, indicating the need for further research to develop evidence-based guidelines for diagnosing these injuries.
Article Abstract
Background: Up to now, there is no convincing evidence, that surgical treatment of deltoid ligament injuries, especially in the setting of ankle fractures, does result in improved outcome. One reason could be a missing diagnostic standard. The aim of the current systematic review was to analyze the applied diagnostic strategies for acute deltoid ligament injuries in outcome studies.
Methods: MEDLINE, Scopus, Central, and EMBASE were searched through February 2022 for any original studies addressing diagnostics of acute deltoid injuries. The study was conducted per the PRISMA guidelines. The inclusion criteria were formed according to the PICOS criteria. The data assessed were study type, level of evidence, included fractures, time point and method of diagnosing deltoid ligament layers, differentiation between layers and syndesmotic injuries.
Results: 31 studies were included in the final analysis. Most studies (n = 28) based their decision to treat the deltoid ligament injury on radiologic findings only, with stressed radiographs (n = 18) being the most common. The radiographs were applied at one or more time points (preoperative, before ORIF, after ORIF, after ORIF and syndesmotic repair). The most frequently assessed parameter was the Medial Clear Space (MCS, n = 27) with cut-off-values considered pathological ranging between MCS > 1 mm and MCS > 6 mm.
Conclusion: Comparing the 31 studies shows that a standardized method to diagnose deltoid ligament injuries is missing. Further research is needed to establish evidence-based guidelines on how to diagnose acute deltoid ligament injuries.
Trial Registration: Prospero ID: CRD42022307112.
Clinical Trial Number: not applicable.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450994 | PMC |
| http://dx.doi.org/10.1186/s12891-024-07869-1 | DOI Listing |
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