Patterns of Ankle Fractures Based on Radiographs and CT Images of ۱۰۰۰ Consecutive Patients

Objectives: The knowledge of different types of ankle fractures based on plain radiographs and computed tomography (CT) images can help improve patients' management.Methods: This cross-sectional study assessed the plain radiographs and CT images of ۱,۰۰۰ consecutive patients observed in an emergency department between March ۲۰۱۵ and March ۲۰۲۰. Fractures were labeled as uni-, bi-, or trimalleolar. Malleolar fractures were classified into medial, lateral, and posterior ones based on Herscovici, DanisWeber, and Mason and Molloy classifications, respectively. Bi- and trimalleolar fractures, on the other hand, were categorized according to the Lauge-Hansen classification.Results: This study included ۱,۰۰۰ patients with ۱,۰۰۳ ankle fractures. Of them, ۹۰۱ were adults (mean±SD age: ۴۱.۶±۱۶.۷, male: ۵۶۷ [۶۲.۹%]) with ۹۰۴ fractures. In total, ۵۳% of adult patients were ۱۸ to ۳۹ years old. Considering unilateral ankle fractures, the medial malleolar fracture was the most common unimalleolar fracture (۶۲.۶%), with Herscovici C being the most frequent subtype (۶۵.۳%). On the other hand, the most common type of lateral malleolar fracture was Danis-Weber type B (۶۵.۵%). There were also ۲۰۹ (۲۳.۳%) bimalleolar and ۱۱۴ (۱۲.۷%) trimalleolar fractures, ۵.۸% (۱۶ fractures) of which could not be classified based on the Lauge-Hansen classification. Unimalleolar fractures were also observed in ۸۷ (۸۷.۹%) children, with the medial malleolar fracture being the most common type (۸۹.۷%).Conclusion: Medial malleolar fractures were the most frequent malleoli in patients observed in the emergency department under study. Among bi- and trimalleolar ankle fractures, supination-external rotation and pronationexternal rotation injuries were the most common patterns. The Lauge-Hansen classification was not applicable in ۵.۸% of bi- and trimalleolar fractures. Level of evidence: IV

کلیدواژه ها:

Ankle ، Ankle fracture ، Bimalleolar ankle fracture ، CT ، Radiograph ، Trimalleolar ankle fracture ، Unimalleolar ankle fracture