$lateral malleolus fracture picture$

Other exclusion criteria were open fractures, Pilon fractures, multiple fractures in the same foot, old fractures more than 3 weeks, pathologic fractures, fractures treated by conservative therapy, patients younger than 18 years, and patients who refused to join in the study. In order to predict the association of medial malleolar fracture with lateral and posterior malleolar fractures as well as to simplify the statistical analysis, we excluded cases of isolated medial malleolar fractures and cases of avulsion malleolar fractures of the tip. The inclusion criteria were patients with medial malleolar fractures enrolled at our department. We prospectively enrolled all consecutive patients with medial malleolar fractures according to inclusion and exclusion criteria from January 1, 2018, to October 31, 2019, at our department of foot and ankle surgery. The present study was performed to describe the novel classification system and to evaluate the clinical significance of the classification. According to the theory, we raised a posterior colliculus-centric classification system based on the 3-D reconstruction CT of medial malleolar fracture. Considering the great clinical significance of fracture line direction and the comminuted morphology for the lateral malleolus, we proposed that it also had clinical significance for the medial malleolus. In the latest years, the posterior colliculus has been considered to be the primary stabilizer of the medial ankle. The medial malleolus is composed of the anterior colliculus, the intercollicular groove, and the posterior colliculus. Unfortunately, all the above classifications were mostly used for the descriptions of fracture morphology based on X-ray film while the clinical significance was unclear.

$lateral malleolus fracture picture$

The Herscovici system is based on the level of medial malleolar fracture and classified into 4 groups: avulsion fractures, between the tip and plafond, at the level of the plafond, and vertical fractures. The Ebraheim system is based on the level and location of the medial malleolar fracture and classified into 4 groups: transverse, oblique, comminuted, and vertical fractures. The Pankovich system and the modified Pankovich system are based on the location of the medial malleolar fracture and the competency of the deltoid ligament and divided the fractures into 6 groups. There have been attempts at introducing classification systems for the medial malleolar fracture. However, all the two classifications were centered on the injury of the lateral malleolus, and the fracture morphology of medial malleolus was little mentioned. Either in isolation or in conjunction with fractures of the lateral and posterior malleolus, displaced medial malleolar fracture has been recommended for operative management however, the classification of the fracture has not been paid much attention by the orthopedic surgeon.įractures of the ankle joint are commonly classified according to the Danis-Weber and Lauge-Hansen systems. The novel classification was a useful system to describe the 3-D geometry of the fractured medial malleolus.įracture of the medial malleolus is one of the most frequent injuries treated by the orthopedic surgeon. Furthermore, comminuted medial malleolar fractures could be subdivided, and the new classification could provide useful information for surgical decision-making. From type 1 to type 4, the ankle joint was more and more unstable.

$lateral malleolus fracture picture$

Results showed that the new classification had implications in the severity of ankle fractures. Statistics showed that the new classification had significant associations but did not totally depend on the classical ankle fracture classifications. The distribution of the cases was type 1 of 12.1%, type 2 of 41.0%, type 3 of 30.0%, and type 4 of 16.8%. There were 273 cases prospectively enrolled. Statistical analyses were performed to evaluate the clinical significance of the classification. Based on the 3-D reconstruction CT morphology and centered on the posterior colliculus of the medial malleolus, we classified the fractures into 4 types: type 1 with no involvement of the posterior colliculus, type 2 with partial involvement of posterior colliculus, type 3 with the entire involvement of posterior colliculus, and type 4 with the fracture line 4 vertically extended from the intercollicular groove to the comminuted fracture of the posterior malleolus. MethodsĬonsecutive cases of medial malleolus fractures were prospectively enrolled. Fracture of the medial malleolus is one of the most frequent injuries treated surgically however, the classification of the fracture has not attracted much attention and a good classification system is still lacking.

$lateral malleolus fracture picture$

Lateral malleolus fracture picture