Allogeneic tendons in the treatment of malunited lateral malleolar avulsion fractures with chronic lateral ankle instability. 2023

Yu Zhang, and Xin Wang, and Xiaomeng Wang, and Jianming Cao, and Huijuan Wang, and Fengqi Zhang
Department of Foot and Ankle Orthopaedics Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China.

BACKGROUND 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. METHODS 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. RESULTS 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 < 0.01). The VAS scores were significantly reduced from a preoperative mean of 6.8 ± 1.0 to 2.8 ± 0.9 postoperatively (p<0.01). CONCLUSIONS In this population and with this follow-up, the application of allogeneic tendons to treat malunited lateral malleolar avulsion fractures combined with chronic lateral ankle instability appeared safe and effective.

UI MeSH Term Description Entries
D007593 Joint Instability Lack of stability of a joint or joint prosthesis. Hypermobility, Joint,Instability, Joint,Laxity, Joint,Hypermobilities, Joint,Instabilities, Joint,Joint Hypermobilities,Joint Hypermobility,Joint Instabilities,Joint Laxities,Joint Laxity,Laxities, Joint
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071562 Fractures, Avulsion Tearing away of the CORTICAL BONE fragment at the location of a strong ligament or tendon attachment. The bone fragment detachment site often occurs near a soft site (e.g., GROWTH PLATE) at the base where LIGAMENTS; TENDONS; or JOINT CAPSULES attach. In younger patients it is most often caused by a sudden forceful pull on a tendon in the opposite direction of the bone movement. In the elderly it is associated with osteoporotic INSUFFICIENCY FRACTURES. Sprain Fracture,Avulsion Fracture,Avulsion Fractures,Fracture, Avulsion,Fracture, Sprain,Fractures, Sprain,Sprain Fractures
D000842 Ankle The region of the lower limb between the FOOT and the LEG. Tarsus,Regio tarsalis,Ankles
D000843 Ankle Joint The joint that is formed by the inferior articular and malleolar articular surfaces of the TIBIA; the malleolar articular surface of the FIBULA; and the medial malleolar, lateral malleolar, and superior surfaces of the TALUS. Ankle Syndesmosis,Articulatio talocruralis,Distal Tibiofibular Joint,Inferior Tibiofibular Joint,Talocrural Joint,Tibiofibular Ankle Syndesmosis,Tibiofibular Syndesmosis,Ankle Joints,Ankle Syndesmoses,Ankle Syndesmosis, Tibiofibular,Distal Tibiofibular Joints,Inferior Tibiofibular Joints,Joint, Ankle,Joints, Ankle,Syndesmosis, Ankle,Talocrural Joints,Tibiofibular Ankle Syndesmoses,Tibiofibular Joint, Distal,Tibiofibular Syndesmoses
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D013710 Tendons Fibrous bands or cords of CONNECTIVE TISSUE at the ends of SKELETAL MUSCLE FIBERS that serve to attach the MUSCLES to bones and other structures. Endotenon,Epotenon,Tendons, Para-Articular,Tendons, Paraarticular,Endotenons,Epotenons,Para-Articular Tendon,Para-Articular Tendons,Paraarticular Tendon,Paraarticular Tendons,Tendon,Tendon, Para-Articular,Tendon, Paraarticular,Tendons, Para Articular
D017844 Lateral Ligament, Ankle LATERAL LIGAMENTS of the ANKLE JOINT. It includes inferior tibiofibular ligaments. Ankle Lateral Ligament,Ligamentum Laterale Articulationis Talocruralis,Anterior Inferior Tibiofibular Ligament,Calcaneofibular Ligament,External Lateral Ligament,Internal Lateral Ankle Ligament,Lateral Collateral Ligament,Posterior Inferior Tibiofibular Ligament,Posterior Talofibular Ligament,Ankle Lateral Ligaments,Calcaneofibular Ligaments,Collateral Ligament, Lateral,Collateral Ligaments, Lateral,External Lateral Ligaments,Lateral Collateral Ligaments,Lateral Ligament, External,Lateral Ligaments, Ankle,Lateral Ligaments, External,Ligament, Ankle Lateral,Ligament, Calcaneofibular,Ligament, External Lateral,Ligament, Lateral Collateral,Ligament, Posterior Talofibular,Ligaments, Ankle Lateral,Ligaments, Calcaneofibular,Ligaments, External Lateral,Ligaments, Lateral Collateral,Ligaments, Posterior Talofibular,Posterior Talofibular Ligaments,Talofibular Ligament, Posterior,Talofibular Ligaments, Posterior
D018380 Hematopoietic Stem Cell Transplantation Transfer of HEMATOPOIETIC STEM CELLS from BONE MARROW or BLOOD between individuals within the same species (TRANSPLANTATION, HOMOLOGOUS) or transfer within the same individual (TRANSPLANTATION, AUTOLOGOUS). Hematopoietic stem cell transplantation has been used as an alternative to BONE MARROW TRANSPLANTATION in the treatment of a variety of neoplasms. Stem Cell Transplantation, Hematopoietic,Transplantation, Hematopoietic Stem Cell
D064386 Ankle Fractures Fractures of any of the bones of the ANKLE. Bimalleolar Ankle Fractures,Bimalleolar Equivalent Ankle Fractures,Bimalleolar Equivalent Fractures,Bimalleolar Fractures,Lateral Malleolus Fractures,Medial Malleolus Fractures,Posterior Malleolus Fractures,Trimalleolar Ankle Fractures,Trimalleolar Fractures,Ankle Fracture,Ankle Fracture, Bimalleolar,Ankle Fracture, Trimalleolar,Bimalleolar Ankle Fracture,Bimalleolar Equivalent Fracture,Bimalleolar Fracture,Equivalent Fracture, Bimalleolar,Fracture, Ankle,Fracture, Bimalleolar,Fracture, Bimalleolar Ankle,Fracture, Bimalleolar Equivalent,Fracture, Lateral Malleolus,Fracture, Medial Malleolus,Fracture, Posterior Malleolus,Fracture, Trimalleolar,Fracture, Trimalleolar Ankle,Lateral Malleolus Fracture,Malleolus Fracture, Lateral,Malleolus Fracture, Medial,Malleolus Fracture, Posterior,Medial Malleolus Fracture,Posterior Malleolus Fracture,Trimalleolar Ankle Fracture,Trimalleolar Fracture

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