Wang J, Stride D, Horner NS, et al. - Researchers conducted a systematic database search with Medline, Pubmed and Embase for relevant studies discussing patients with ankle fractures involving deltoid ligament rupture and repair. They conducted screening, quality assessment and data extraction independently and in duplicate. Between 1990 to 2018, nine eligible studies were included (N=508) after screening. In comparison to transsyndesmotic screws, deltoid ligament repair offers lower syndesmotic malreduction rates and reduced re-operation rates for hardware removal. It was shown that repair groups indicated equivalent or better outcomes for pain, function, ROM, MCS and complication rates. According to the findings, other newer syndesmotic fixation methods such as suture-button fixation need future assessment when compared to the outcomes of deltoid ligament repair. A randomized control trial is needed to further analyze the outcomes of ankle fracture patients who undergo deltoid ligament repair versus transsyndesmotic screw fixation.