Treatment of the fresh lateral malleolus avulsion fracture by using the all ankle arthroscope for anterior talofibular ligament repairing

Abstract

Objective To investigate the therapeutic efficacy of treating fresh lateral malleolus avulsion fracture by using the all ankle arthroscope for anterior talofibular ligament repairing. Methods From January 2016 to March 2017, 36 patients (36 ankles) of fresh lateral malleolus avulsion fracture were retrospectively followed in Xuzhou Central Hospital. There were 22 males and 14 females, aged from 18 to 57 years with a median of (29.24±10.37) years. Among them, the right and the left sides were involved in 20 and 16 cases, respectively. All the patients were treated by using the all ankle arthroscopy technique combined with anchor fixation for anterior talofibular ligament repairing. The appearance of the ankle, the stability of the ankle joint and the walking gait were observed after the operation. The effect of the operation was evaluated by visual analogue scale(VAS), American Orthopaedic Foot and Ankle Society(AOFAS) and Olerud-Molander scores at the last follow-up. The preoperative VAS, AOFAS and Olerud-Molander scores were 5-8(6.35±1.17), 60-85(74.67±8.36) and 57-80(68.89±10.70), respectively. Results The incision healed by first intention, without evidence of postoperative complications of nerve, vessel and tendon injury. Thirty-six patients were successfully followed up for 12 to 25 months (average 14.6±6.80 months). At the final follow-up, no case reported skin hyperalgesia or scar tenderness, the perfect skin appearance, normal ankle function and normal walking gait were regained in all the cases without ankle pain and bearing walking pain. At the final follow up, the scores of the VAS, AOFAS, and Olerud-Molander were(0.31±0.14), (90.40±9.62) and (88.71±7.38), which were statistically different from those before surgery (t=30.755, 7.405 and 9.149, all P values<0.05). Conclusions Treatment of anterior talofibular ligament injury with all ankle arthroscopy procedure has the advantages of safety, reliability, effectiveness and small trauma. It is an effective method for the treatment for the avulsion fracture of the lateral malleolus of the anterior talofibular ligament. Key words: Ankle injuries; Lateral ligament, ankle; Anterior talofibular ligament; Surgical procedures, arthroscopic; Lateral malleolus fracture