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Ankle Fracture Spur Sign Is Pathognomonic for a Variant Ankle Fracture
- Source :
- Foot & Ankle International. 36:159-164
- Publication Year :
- 2014
- Publisher :
- SAGE Publications, 2014.
-
Abstract
- Background: The hyperplantarflexion variant ankle fracture is composed of a posterior tibial lip fracture with posterolateral and posteromedial fracture fragments separated by a vertical fracture line. This infrequently reported injury pattern often includes an associated “spur sign” or double cortical density at the inferomedial tibial metaphysis. The objective of this study was to quantitatively establish the association of the ankle fracture spur sign with the hyperplantarflexion variant ankle fracture. Methods: Our clinical database of operative ankle fractures was retrospectively reviewed for the incidence of hyperplantarflexion variant and nonvariant ankle fractures as determined by assessment of injury radiographs, preoperative advanced imaging, and intraoperative observation. Injury radiographs were then evaluated for the presence of the spur sign, and association between the spur sign and variant fractures was analyzed. Results: The incidence of the hyperplantarflexion variant fracture among all ankle fractures was 6.7% (43/640). The spur sign was present in 79% (34/43) of variant fractures and absent in all nonvariant fractures, conferring a specificity of 100% in identifying variant fractures. Positive predictive value and negative predictive value were 100% and 99%, respectively. Conclusion: The ankle fracture spur sign was pathognomonic for the hyperplantarflexion variant ankle fracture. It is important to identify variant fractures preoperatively as patient positioning, operative approach, and fixation construct of variant fractures often differ from those employed for osteosynthesis of nonvariant fractures. Identification of the spur sign should prompt acquisition of advanced imaging to formulate an appropriate operative plan to address the variant fracture pattern. Level of Evidence: Level III, retrospective comparative study.
- Subjects :
- Adult
Male
Ankle Fractures
Fracture Fixation, Internal
Pathognomonic
medicine
Humans
Orthopedics and Sports Medicine
Ankle Injuries
Vertical fracture
Aged
Retrospective Studies
Tibia
business.industry
Anatomy
Middle Aged
Magnetic Resonance Imaging
medicine.anatomical_structure
Fracture (geology)
Spur
Female
Surgery
Ankle
Tomography, X-Ray Computed
business
Ankle Joint
Sign (mathematics)
Subjects
Details
- ISSN :
- 19447876 and 10711007
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Foot & Ankle International
- Accession number :
- edsair.doi.dedup.....c870bade6540d79b852d2f18b01b2736