Are SER-II Ankle Fractures Anatomic? Computed Tomography Demonstrates Mortise Malalignment in the Setting of Apparently Normal Radiographs.

IF 1.8 Q2 ORTHOPEDICS
Bonnie Y Chien, Eitan M Ingall, Steven Staffa, Caroline Williams, Christopher P Miller, John Y Kwon
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引用次数: 0

Abstract

Background: Ankle fracture treatment is predicated on minimal displacement, leading to abnormal joint contact area. The purpose of this investigation is to determine whether computed tomography (CT) detects subtle mortise malalignment undetectable by x-ray in supination-external rotation-II (SER-II) injuries.

Methods: A total of 24 patients with SER-II injuries, as demonstrated by negative gravity stress radiography, were included. Medial clear space (MCS) measurements were performed on bilateral ankle x-rays (injured and contralateral, uninjured side) at several time points as well as bilateral non-weight-bearing CT performed once clinical and radiographic healing was demonstrated (mean = 66 days post injury, range = 61-105 days). Statistical analyses examined differences in measurements between both sides.

Results: Final x-rays demonstrated no differences between normal and injured ankle MCS (P = .441). However, CT coronal/axial MCS measurements were different (P < .05). CT coronal MCS measured wider by a mean difference of 0.67 mm (P < .001).

Conclusion: There is a high incidence of subtle mortise malalignment in SER-II ankle fractures, as demonstrated by CT, which is undetectable when assessed by plain radiographs. Although clinical outcomes are yet unknown, there are important implications of the finding of confirmed, subtle mortise malalignment in SER-II injuries and the limitations of x-ray to detect it.

Level of evidence: Level III.

SER-II型踝关节骨折是解剖性的吗?计算机断层扫描显示在表面正常的x线片上出现榫槽错位。
背景踝关节骨折的治疗以最小位移为前提,导致关节接触面积异常。本研究的目的是确定计算机断层扫描(CT)是否检测到旋后外旋II(SER-II)损伤中x射线无法检测到的细微榫眼错位。方法纳入24例SER-II损伤患者,如重力负应力射线照相所示。在几个时间点对双侧踝关节x光片(受伤侧和对侧、未受伤侧)进行内侧间隙(MCS)测量,并在临床和放射学愈合后进行双侧非承重CT测量(平均值=受伤后66天,范围=61-105天)。统计分析检验了双方测量结果的差异。结果最终x光片显示正常和受伤的踝关节MCS之间没有差异(P=.441)。然而,CT冠状/轴向MCS测量值不同(P<.05)。CT冠状MCS测量值更宽,平均差异为0.67mm(P<.001)。结论SER-II踝关节骨折中细微的榫眼错位发生率很高,如CT所示,其在通过平片射线照片评估时是不可检测的。尽管临床结果尚不清楚,但SER-II损伤中发现的已证实的、细微的榫眼错位以及x射线检测的局限性具有重要意义。证据水平III。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Foot and Ankle Specialist
Foot and Ankle Specialist Health Professions-Podiatry
CiteScore
3.10
自引率
0.00%
发文量
100
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