The role of anatomical repair of the anterior inferior tibiofibular ligament in acute ankle fractures with syndesmotic injury: A systematic review
Bibliographic record
Abstract
The management of syndesmotic injury in ankle fractures is still controversial. Anterior inferior tibiofibular ligament (AITFL) primary repair is considered essential to reduce the risk of syndesmotic malreduction. This review examined the available literature on primary AITFL repair in ankle fractures. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Web of Science, Cochrane, and Google Scholar were searched up to July 15, 2021, for articles reporting on the repair of AITFL in acute ankle fractures with syndesmotic injury. The quality of the included studies was assessed using the Newcastle-Ottawa scale. Studies that investigated isolated syndesmotic injury without ankle fracture, reviews, cadaveric studies, case reports, and studies not published in English were excluded from the study. The search yielded 588 articles, of which three studies were included, with a total of 229 AITFL primary repairs. The articles were excluded due to different design, foreign language, irrelevancy, or no syndesmosis injury, including patients with isolated syndesmosis injury or used methods of repair other than anatomical repair. Early functional outcomes were found better after AITFL repair compared to syndesmotic screw fixation alone. Moreover, time to return to play/work was significantly lower in the anatomical repair compared to temporary screw fixation. Anatomical repair of the ankle syndesmosis is an effective and safe method with good functional outcomes and return to activity. However, the future prospective studies are required to assess the efficacy of the anatomical repair of the syndesmosis and its superiority over other treatments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.030 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.009 |
| Bibliometrics | 0.012 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".