Evidence map›Paper›PMID 39772838›Full record

ReviewFoot & ankle specialist2026

Repairing the Deltoid Ligament in Ankle Fractures: Is it time for a Paradigm Shift?

Joy Van den Berg, Diederick Penning, Sebastian Baumbach, Tim Schepers

Abstract readReview
In one paragraph

Review in Foot & ankle specialist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. The Diagnosis, Treatment, and Aftercare of Ankle Fractures.Deutsches Arzteblatt international · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Joy Van den BergTrauma Unit, Department of Surgery, Amsterdam UMC (Location AMC), University of Amsterdam, Amsterdam, The Netherlands.ORCID 0009-0003-2396-4523
Diederick PenningTrauma Unit, Department of Surgery, Amsterdam UMC (Location AMC), University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0003-1355-1322
Sebastian BaumbachDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich, University Hospital, LMU Munich, Munich, Germany.
Tim SchepersTrauma Unit, Department of Surgery, Amsterdam UMC (Location AMC), University of Amsterdam, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BackgroundIt remains unclear whether repairing the deltoid ligament (DL) is beneficial in acute ankle fractures. The aim of this review is to critically review the developments in deltoid ligament repair (DLR) in ankle fractures over the course of 44 years.MethodAn electronic search was conducted on the PubMed and Embase database including comparative studies evaluating the effect of performing DLR in adults suffering from a closed acute ankle fracture with suspected rupture of the DL.ResultsA total of 27 studies were retrieved, of which only one was a randomized study. A total of 1327 patients were reviewed (663 undergoing DLR and 664 receiving non-DLR treatment for an acute ankle fracture). Although earlier studies concluded that DLR holds little necessity in ankle fracture treatment if the anatomy of the ankle is restored, more recent studies support DLR due to more favorable clinical and radiographic outcomes.DiscussionAll studies agree that restoration of the ankle anatomy to its pre-fracture state is necessary to achieve the best clinical outcome. However, there is still controversy in whether to standardize DLR in ankle fracture treatment. The literature shows a clear shift toward more frequent restoration of the DL, and in light of improved surgical techniques and implants, there is a need for more rigorous studies to provide a clear indication for DLR in acute ankle fracture treatment.Level of Evidence:

Indexed as

Ankle FracturesFracture Fixation, InternalLigaments, ArticularHumansTreatment Outcomeankle fracturedeltoid ligamentdeltoid ligament repairinstabilitymedial collateral ligament

Identifiers

PMID39772838
PMCPMC13323909

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.