Deltoid Ligament Augmentation Shows Promise as Alternative to Screw Fixation for Ankle Fractures

A randomized controlled trial investigated whether the deltoid ligament augmentation (DLA) could replace trans-syndesmotic screw fixation (TSSF). 

Study design and results

The study enrolled 59 patients, including 30 receiving DLA and 29 receiving TSSF, and followed them for one year. The AOFAS score was the primary outcome measure. 

Key findings:

• At one year, both approaches produced equivalent AOFAS scores.

• At three months, the DLA group showed better AOFAS scores and better performance on the Philips & Schwartz scale and SF-36 physical and social scores.

• DLA patients returned to partial/full weight-bearing, work, and sports faster.

• Radiographic evaluation at one year showed no differences.

• Neither group experienced major complications.

Clinical implications

DLA delivers similar one-year outcomes but faster early recovery versus screw fixation. These findings establish DLA as a viable alternative treatment option for ankle fractures with deltoid rupture and syndesmotic instability.