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Relationship between fracture morphology of lateral malleolus and syndesmotic stability after supination-external rotation type ankle fractures.
- Source :
-
Injury [Injury] 2019 Jul; Vol. 50 (7), pp. 1382-1387. Date of Electronic Publication: 2019 May 22. - Publication Year :
- 2019
-
Abstract
- Background: Syndesmotic injury with supination-external rotation (SER)-type ankle fractures are well known for the serious damages to the osseous and soft tissue envelope. However, the Lauge-Hansen classification system does not provide sufficient information related to syndesmotic injury. In this study, we aimed to investigate factors for preoperative detection of syndesmotic injury according to fracture patterns in SER III and IV ankle fractures by using radiography and computed tomography (CT).<br />Methods: All operative SER III and IV ankle fractures treated by a single surgeon from 2009 to 2015 were enrolled in a retrospective database. Based on computed tomographic evidence and intra-operative Cotton test, stable and unstable groups of the ankle factures were divided.<br />Results: A total of 52 patients with SER III, 75 patients with SER IV, and 27 patients with SER IV equivalent ankle fractures were identified, with 106 in the unstable syndesmosis group (68.8%) and 48 patients in the stable syndesmosis group (31.2%). Medial space widening and fragment angle of the fibular posterior cortex were significant predictors. The cutoff values of these factors were 4.4 mm and 32.8 degrees, respectively.<br />Conclusions: CT was superior to simple radiography in predicting syndesmotic injury at the preoperative period in SER-type III and IV. Medial space widening and fragment angle of the fibular posterior cortex, as predictive factors, showed significant correlations. In particular, sharper fragment angle of the posterior cortex indicated higher probability of instability that remained after fracture fixation.<br /> (Copyright © 2019 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Ankle Fractures diagnostic imaging
Ankle Fractures surgery
Ankle Injuries diagnostic imaging
Ankle Injuries surgery
Female
Humans
Male
Middle Aged
Range of Motion, Articular
Retrospective Studies
Supination physiology
Treatment Outcome
Weight-Bearing
Ankle Fractures physiopathology
Ankle Injuries physiopathology
Ankle Joint physiopathology
Fracture Fixation, Internal methods
Radiography methods
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0267
- Volume :
- 50
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Injury
- Publication Type :
- Academic Journal
- Accession number :
- 31174871
- Full Text :
- https://doi.org/10.1016/j.injury.2019.05.020