The Clinical Effect Of Repairing And Not Repairing The Deltoid Ligament For Ankle Joint Fracture With Deltoid Ligament Injury: A Meta-analysis

Objective:Meta-analysis of the literature on surgery and conservative treatment of deltoid ligament injury was performed to compare the clinical efficacy of the two methods.Methods:Search in Pub Med,Cochrane Library,Embase,CNKI,Wanfang Medical Network database,collect literature on the use of conservative and surgical repair of the deltoid ligament to treat deltoid ligament injury,formulate literature inclusion and exclusion criteria,extract data from the selected literature,and select after the operation,the American Association of Foot and Ankle Surgery Ankle-Posterior Ankle Score(AOFAS),the angle of inclination of the talus after treatment,the medial space after treatment(MDS),the visual analogue score(VAS)after treatment;evaluation index of clinical effect.Use software R3.6.3 for statistical analysis and processing of data.Results:A total of 11 articles were included,with a total of 591 patients.Among them,there were 277 cases of surgical repair of the deltoid ligament(test group)and 314 cases of conservative treatment of deltoid ligament injury(control group).After treatment,the American Association of Foot and Ankle Surgery Ankle-Posterior Ankle Score(AOFAS),the angle of inclination of the talus after treatment,the medial space after treatment(MDS),the visual analogue score(VAS)after treatment,and the number of adverse events after treatment perform statistical analysis;Search Pub Med,Cochrane Library,Embase,CNKI,Wanfang Medical Network and other databases,and get a total of 1567articles(863 articles in Pub Med database,353 articles in Embase database,15 articles in Cochrane Library,and 280 articles in CNKI,56 articles from Wanfang Medical Network),11 articles were finally included,including 6 articles in English and 5 articles in Chinese.Statistical analysis was performed on the relevant data in 8 studies involving AOFAS.AOFAS score [SMD=0.63,95%CI=(0.1352,1.1193),Z=2.50,P < 0.05],and The relevant data of the angle of inclination of the talus after treatment in the 3 studies of the company were statistically analyzed and processed.After treatment,the inclination angle of the talus [SMD=-3.3452,95%CI=(-7.0598,0.3694),Z=-1.77,P>0.05],The relevant data in the 7 studies of the medial malleolus space was statistically analyzed and processed.After treatment,the medial malleolus space[SMD=-0.65,95%CI=(-0.90,-0.41),Z=5.12,P<0.05].The relevant data in the 6 studies involving VAS after treatment were statistically analyzed and processed,and the VAS score after treatment [SMD=-1.7623,95%CI=(-3.2320,-0.2926),Z=-2.35,P < 0.05],statistical analysis and processing of the relevant data in 7 studies involving the number of adverse events after treatment,the number of adverse events after treatment [OR=-0.3207,95%CI=(0.1459,0.7049),Z=-2.83,P <0.05].Conclusion:Compared with conservative patients,patients with surgical repair of deltoid ligament injury had higher AOFAS scores,smaller medial malleolus space after treatment,lower postoperative VAS scores,and fewer adverse reactions.