Allogeneic tendons in the treatment of malunited lateral malleolar avulsion fractures with chronic lateral ankle instability

• Published in: BMC musculoskeletal disorders 2023-04, Vol.24 (1), p.273-273, Article 273
• Main Authors: Zhang, Yu, Wang, Xin, Wang, Xiaomeng, Cao, Jianming, Wang, Huijuan, Zhang, Fengqi
• Format: Article
• Language: English
• Subjects: Allograft tendon; Ankle; Ankle Fractures - diagnostic imaging; Ankle Fractures - surgery; Ankle Joint - diagnostic imaging; Ankle Joint - surgery; Arthritis; Avulsion fractures; Care and treatment; Cartilage; Chronic lateral ankle instability; Diagnosis; Fractures; Fractures, Avulsion; Hematopoietic Stem Cell Transplantation; Humans; Injuries; Instability; Joint and ligament injuries; Joint Instability - diagnostic imaging; Joint Instability - etiology; Joint Instability - surgery; Lateral Ligament, Ankle - surgery; Lateral malleolar ligament reconstruction; Lateral malleolus avulsion fracture; Musculoskeletal diseases; Orthopedic surgery; Patient outcomes; Patient satisfaction; Patients; Recovery of function; Retrospective Studies; Sports injuries; Statistical analysis; Surgery; Talus; Tendons
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-023-06390-1

The aim of this study is to report our institution's experience regarding the application of allogeneic tendons for the reconstruction of malunited lateral malleolar avulsion fractures with chronic lateral ankle instability. This retrospective study included 34 (34 ankles) patients surgically treated for malunited lateral malleolar avulsion fractures with chronic lateral ankle instability from January 2016 to December 2019. All patients underwent allogeneic tendon reconstruction. The pre- and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) scores、Karlsson Ankle Functional Scores (KAFS) and visual analogue scale (VAS) scores were used to evaluate the functional recovery of the ankle joint. The final follow-up, based on radiographic assessment, including talar tilt and anterior talar translation, was performed to evaluate the stability of the postoperative ankle joints. Thirty-two patients (32 ankles) returned for final clinical and radiologic follow-up at an average of 29 (range 24-35) months and 2 patients (2 ankles) were lost to follow-up. The preoperative talus inclination angle (13.6 ± 1.9°) and anterior displacement (9.6 ± 2.8 mm) were re-examined under X-ray and found to be reduced to 3.4 ± 1.2° and 3.8 ± 1.1 mm, respectively (p＜0.01). The AOFAS scores increased from 58.5 ± 4.0 to 90.9 ± 3.8 and the Karlsson scores improved from 52.2 ± 3.6 to 89.8 ± 4.5, which was obviously better and the difference was statistically significant (P