Acute Ankle Diastasis Injuries Treated with Dynamic, Static Fixation or Anatomic Repair: A Meta-Analysis and...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Traumatology

Background:

• Acute ankle diastasis injuries compromise the syndesmotic complex, leading to debilitating outcomes.
• Current treatments include static fixation, dynamic fixation, and anatomic repair, with ongoing debate on optimal effectiveness.

Purpose of the Study:

• To compare the efficacy of static fixation, dynamic fixation, and anatomic repair for acute syndesmotic injuries.

Main Methods:

• Systematic literature search of Embase and PubMed.
• Analysis of 21 studies (1,059 patients) comparing treatment groups.
• Statistical analysis using Review Manager 5.4 (p ≤ 0.05).

Main Results:

• Dynamic fixation showed superior American Orthopaedic Foot & Ankle Society (AOFAS) scores at multiple time points compared to static fixation.
• Anatomic repair also yielded higher AOFAS scores than static fixation at 6 months and 1 year.
• Dynamic fixation demonstrated significantly lower implant failures and reoperation rates compared to static and anatomic repair.

Conclusions:

• Dynamic fixation offers superior early clinical outcomes and reduced complications, particularly implant failures and reoperations.
• While early advantages of dynamic fixation may lessen over time, it remains a favorable option.
• Anatomic repair showed limited advantages over static fixation in long-term outcomes, complications, or reoperation rates.