Stability evaluation of the “equivalent” ankle bimalleolar fractures

a comparative study

Authors

  • Isabel Rosa
  • Joaquim Rodeia
  • Pedro Xavier Fernandes
  • Raquel Teixeira
  • Hugo Ribeiro
  • Luís Sobral

Keywords:

Ankle fractures, Deltoid ligament/ injury, Gravity-stress radiography, Manual-stress radiography, Medial clear space

Abstract

With an incidence of 125/100,000/year, the ankle malleolar fractures are often diagnosed in young male and old female. The supination-external rotation fractures (SE), also known as AO Weber B are the most commonly seen in around 80% of them all. To identify the absence or presence of a deltoid ligament injury in an undisplaced isolated lateral malleolar fracture remains the key point to differentiate between the stable and unstable types. We know that the latter, if operated, has a better outcome which might decrease early post-traumatic osteoarthritis. How can we check the competence of the deltoid ligament in an isolated fibular fracture with a normal medial clear space in X-ray? The authors intends to assess the competence of the deltoid ligament in malleolar fracture using Gravity stress radiographs and an external rotation stress test under fluoroscopy as a diagnostic tool. A consecutive series of patients with isolated lateral malleolar fractures (Lauge-Hansen SER type) were prospectively enrolled from 10 February 2016 to 30 November 2017. Patients with unstable fractures (medial clear space (MCS) ≥4 mm on the radiograph was operated. Gravity stress radiographs and an external rotation stress test under fluoroscopy provide a reliable basis to decide about stability and operative treatment in isolated lateral malleolar fractures of the SER type.

Author Biographies

Isabel Rosa

Hospital de São Francisco Xavier, CHLO, Lisboa, Portugal.

Joaquim Rodeia

Hospital de São Francisco Xavier, CHLO, Lisboa, Portugal.

Pedro Xavier Fernandes

Hospital de São Francisco Xavier, CHLO, Lisboa, Portugal.

Raquel Teixeira

Hospital de São Francisco Xavier, CHLO, Lisboa, Portugal.

Hugo Ribeiro

Hospital de São Francisco Xavier, CHLO, Lisboa, Portugal.

Luís Sobral

Hospital de São Francisco Xavier, CHLO, Lisboa, Portugal.

Published

2018-07-20

How to Cite

Rosa, I., Rodeia, J., Fernandes, P. X., Teixeira, R. ., Ribeiro, H., & Sobral, L. (2018). Stability evaluation of the “equivalent” ankle bimalleolar fractures: a comparative study. Tobillo Y Pie, 10(1), 9–13. Retrieved from https://scijfootankle.emnuvens.com.br/tobilloypie/article/view/1322

Issue

Section

Original Articles