Acute Deltoid Injury in Ankle Fractures: A Biomechanical Analysis of Different Repair Constructs

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dc.coverageDOI: 10.1177/10711007231184844
dc.creatorWagner, Emilio
dc.creatorWagner, Pablo
dc.creatorEscudero, Mario I.
dc.creatorPacheco, Florencia
dc.creatorSalinas, David
dc.creatorGodoy-Santos, Alexandre Leme
dc.creatorPalma, Felipe
dc.creatorGuzmán-Venegas, Rodrigo
dc.creatorBerral–De la Rosa, Francisco Jose
dc.date2023
dc.date.accessioned2025-11-18T19:49:23Z
dc.date.available2025-11-18T19:49:23Z
dc.description<p>Background: The importance of the deltoid ligament in the congruency and coupling of the tibiotalar joint is well known. The current trend is to repair it in cases of acute injuries in the context of ankle fractures; however, there is limited information on how it should be reconstructed. The objective of this study was to compare different deltoid ligament repair types in an ankle fracture cadaveric model. Methods: Sixteen cadaveric foot-ankle-distal tibia specimens were used. All samples were prepared as a supination external rotation ankle fracture model. Axial load and cyclic axial rotations were applied on every specimen using a specifically designed frame. This test was performed without deltoid injury, with deltoid injury, and after repair. The reconstruction was performed in 4 different ways (anterior, posterior, middle, and combined). Medial clear space (MCS) was measured for each condition on simulated weightbearing (WB) and gravity stress (GS) radiographs. Reflective markers were used in tibia and talus, registering the kinematics through a motion analysis system to record the tibiotalar uncoupling. Results: After deltoid damage, in all cases the MCS increased significantly on GS radiographs, but there was no increase in the MCS on WB radiographs. After repair, in all cases, the MCS was normalized. Kinematically, after deltoid damage, the tibiotalar uncoupling increased significantly. All isolated repairs achieved a similar tibiotalar uncoupling value as its baseline condition. The combined repair resulted in a significant decrease in tibiotalar uncoupling. Conclusion: Our results show that deltoid repair recovers the tibiotalar coupling mechanism in an ankle fracture model. Isolated deltoid repairs recovered baseline MCS and tibiotalar uncoupling values. Combined repairs may lead to overconstraint, which could lead to postoperative stiffness. Clinical studies are needed to prove these results and show clinically improved outcomes. Clinical Relevance: This study helps in finding the optimum deltoid repair to use in an acute trauma setting.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/a8ea8601-16e0-45bf-9357-4b443310e97e
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/56052
dc.languageeng
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.sourcevol.44 (2023) nr.9 p.10711007231184844
dc.subjectankle fractures
dc.subjectbiomechanics
dc.subjectcadaveric study
dc.subjectdeltoid ligament
dc.subjectdeltoid repair
dc.titleAcute Deltoid Injury in Ankle Fractures: A Biomechanical Analysis of Different Repair Constructseng
dc.typeArticleeng
dc.typeArtículospa
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