martes, 3 de abril de 2018

Morphological characteristics of the posterior malleolar fragment according to ankle fracture patterns: a computed tomography-based study | BMC Musculoskeletal Disorders | Full Text

Morphological characteristics of the posterior malleolar fragment according to ankle fracture patterns: a computed tomography-based study | BMC Musculoskeletal Disorders | Full Text

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BMC Musculoskeletal Disorders

Morphological characteristics of the posterior malleolar fragment according to ankle fracture patterns: a computed tomography-based study

  • Young Yi,
  • Dong-Il Chun,
  • Sung Hun Won,
  • Suyeon Park,
  • Sanghyeon Lee and
  • Jaeho ChoEmail author
Contributed equally
BMC Musculoskeletal DisordersBMC series – open, inclusive and trusted201819:51
Received: 17 September 2017
Accepted: 8 February 2018
Published: 13 February 2018

Abstract

Background

The posterior malleolar fragment (PMF) of an ankle fracture can have various shapes depending on the injury mechanism. The purpose of this study was to evaluate the morphological characteristics of the PMF according to the ankle fracture pattern described in the Lauge-Hansen classification by using computed tomography (CT) images.

Methods

We retrospectively analyzed CT data of 107 patients (107 ankles) who underwent surgery for trimalleolar fracture from January 2012 to December 2014. The patients were divided into two groups: 76 ankles in the supination-external rotation (SER) stage IV group and 31 ankles in the pronation-external rotation (PER) stage IV group. The PMF type of the two groups was assessed using the Haraguchi and Jan Bartonicek classification. The cross angle (α), fragment length ratio (FLR), fragment area ratio (FAR), sagittal angle (θ), and fragment height (FH) were measured to assess the morphological characteristics of the PMF.

Results

The PMF in the SER group mainly had a posterolateral shape, whereas that in the PER group mainly had a posteromedial two-part shape or a large posterolateral triangular shape (P = 0.02). The average cross angle was not significantly different between the two groups (SER group = 19.4°, PER group = 17.6°). The mean FLR and FH were significantly larger in the PER group than in the SER group (P = 0.024, P = 0.006). The mean fragment sagittal angle in the PER group was significantly smaller than that in the SER group (P = 0.017).

Conclusions

With regard to the articular involvement, volume, and vertical nature, the SER-type fracture tends to have a smaller fragment due to the rotational force, whereas the PER-type fracture tends to have a larger fragment due to the combination of rotational and axial forces.

Keywords

Ankle fractureComputed tomographyPosterior malleolar fragmentMorphology

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