Skip to main content

06.04.2024 | Review Article

Radiologic evaluation of ankle fracture malunions of the fibula

verfasst von: Sam Si-Hyeong Park, Timothy L. Miao, Ali Naraghi, Dorota Linda, Lawrence M. White

Erschienen in: Skeletal Radiology

Einloggen, um Zugang zu erhalten

Abstract

Ankle fractures involving the distal fibula are common injuries. Malreductions and subsequent malunions of the distal fibula can result in worse clinical outcomes and posttraumatic arthritis. The ability to accurately evaluate and identify malreductions and malunions of the distal fibula is important. A number of different radiographic and CT measurements have been described to assess fibular length and rotation. This review highlights various radiologic measures and discusses their advantages and limitations.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Court-Brown C, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37(8):691–7.CrossRefPubMed Court-Brown C, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37(8):691–7.CrossRefPubMed
2.
Zurück zum Zitat Egger A, Berkowitz M. Operative treatment of the malunited fibula fracture. Foot Ankle Int. 2018;39(10):1242–52.CrossRefPubMed Egger A, Berkowitz M. Operative treatment of the malunited fibula fracture. Foot Ankle Int. 2018;39(10):1242–52.CrossRefPubMed
3.
Zurück zum Zitat Elsoe R, Ostgaard S, Larsen P. Population-based epidemiology of 9767 ankle fractures. Foot Ankle Surg. 2018;24(1):34–9.CrossRefPubMed Elsoe R, Ostgaard S, Larsen P. Population-based epidemiology of 9767 ankle fractures. Foot Ankle Surg. 2018;24(1):34–9.CrossRefPubMed
4.
Zurück zum Zitat Cammas C, Ancion A, Detrembleur C, Tribak K, Putineanu D, Cornu O. Frequency and risk factors of complications after surgical treatment of ankle fractures : a retrospective study of 433 patients. Acta Orthop Belg. 2020;86(3):563–74.PubMed Cammas C, Ancion A, Detrembleur C, Tribak K, Putineanu D, Cornu O. Frequency and risk factors of complications after surgical treatment of ankle fractures : a retrospective study of 433 patients. Acta Orthop Belg. 2020;86(3):563–74.PubMed
5.
Zurück zum Zitat Thordarson D, Motamed S, Hedman T, Ebramzadeh E, Bakshian S. The effect of fibular malreduction on contact pressures in an ankle fracture malunion model. J Bone Joint Surg Am. 1997;79(12):1809–15.CrossRefPubMed Thordarson D, Motamed S, Hedman T, Ebramzadeh E, Bakshian S. The effect of fibular malreduction on contact pressures in an ankle fracture malunion model. J Bone Joint Surg Am. 1997;79(12):1809–15.CrossRefPubMed
7.
Zurück zum Zitat Saltzman CL, Salamon ML, Blanchard GM, et al. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J. 2005;25:44–6.PubMedPubMedCentral Saltzman CL, Salamon ML, Blanchard GM, et al. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J. 2005;25:44–6.PubMedPubMedCentral
8.
Zurück zum Zitat Sagi H, Shah A, Sanders R. The functional consequence of syndesmotic joint malreduction at a minimum 2-year follow-up. J Orthop Trauma. 2012;26(7):439–43.CrossRefPubMed Sagi H, Shah A, Sanders R. The functional consequence of syndesmotic joint malreduction at a minimum 2-year follow-up. J Orthop Trauma. 2012;26(7):439–43.CrossRefPubMed
9.
Zurück zum Zitat Ovaska M, Mäkinen T, Madanat R, Kiljunen V, Lindahl J. A comprehensive analysis of patients with malreduced ankle fractures undergoing re-operation. Int Orthop. 2014;38(1):83–8.CrossRefPubMed Ovaska M, Mäkinen T, Madanat R, Kiljunen V, Lindahl J. A comprehensive analysis of patients with malreduced ankle fractures undergoing re-operation. Int Orthop. 2014;38(1):83–8.CrossRefPubMed
10.
Zurück zum Zitat Sarkisian J, Cody G. Closed treatment of ankle fractures: a new criterion for evaluation - a review of 250 case. J Trauma. 1976;16(4):323–6.CrossRefPubMed Sarkisian J, Cody G. Closed treatment of ankle fractures: a new criterion for evaluation - a review of 250 case. J Trauma. 1976;16(4):323–6.CrossRefPubMed
11.
Zurück zum Zitat Rolfe B, Nordt W, Sallis J, Distefano M. Assessing fibular length using bimalleolar angular measurements. Foot Ankle. 1989;10(2):104–9.CrossRefPubMed Rolfe B, Nordt W, Sallis J, Distefano M. Assessing fibular length using bimalleolar angular measurements. Foot Ankle. 1989;10(2):104–9.CrossRefPubMed
12.
Zurück zum Zitat Brage M, Bennett C, Whitehurst J, Getty P, Toledano A. Observer reliability in ankle radiographic measurements. Foot Ankle Int. 1997;18(6):324–9.CrossRefPubMed Brage M, Bennett C, Whitehurst J, Getty P, Toledano A. Observer reliability in ankle radiographic measurements. Foot Ankle Int. 1997;18(6):324–9.CrossRefPubMed
13.
Zurück zum Zitat Pitakveerakul A, Kungwan S, Arunakul P, Arunakul M. Radiographic parameters in gravity stress view of the ankle: normative data. Foot Ankle Surg. 2019;25(6):819–25.CrossRefPubMed Pitakveerakul A, Kungwan S, Arunakul P, Arunakul M. Radiographic parameters in gravity stress view of the ankle: normative data. Foot Ankle Surg. 2019;25(6):819–25.CrossRefPubMed
14.
Zurück zum Zitat Magid D, Michelson JD, Ney DR, Fishman EK. Adult ankle fractures: comparison of plain films and interactive two- and three-dimensional CT scans. AJR Am J Roentgenol. 1990;154(5):1017–23.CrossRefPubMed Magid D, Michelson JD, Ney DR, Fishman EK. Adult ankle fractures: comparison of plain films and interactive two- and three-dimensional CT scans. AJR Am J Roentgenol. 1990;154(5):1017–23.CrossRefPubMed
15.
Zurück zum Zitat Panchbhavi V, Gurbani B, Mason C, Fischer W. Radiographic Assessment of Fibular Length Variance: The Case for “Fibula Minus.” J Foot Ankle Surg. 2018;57(1):91–4.CrossRefPubMed Panchbhavi V, Gurbani B, Mason C, Fischer W. Radiographic Assessment of Fibular Length Variance: The Case for “Fibula Minus.” J Foot Ankle Surg. 2018;57(1):91–4.CrossRefPubMed
16.
17.
Zurück zum Zitat Tang C, Roidis N, Vaishnav S, Patel A, Thordarson D. Position of the distal fibular fragment in pronation and supination ankle fractures: a CT evaluation. Foot Ankle Int. 2003;24(7):561–6.CrossRefPubMed Tang C, Roidis N, Vaishnav S, Patel A, Thordarson D. Position of the distal fibular fragment in pronation and supination ankle fractures: a CT evaluation. Foot Ankle Int. 2003;24(7):561–6.CrossRefPubMed
18.
Zurück zum Zitat Marmor M, Hansen E, Han H, Buckley J, Matityahu A. Limitations of standard fluoroscopy in detecting rotational malreduction of the syndesmosis in an ankle fracture model. Foot Ankle Int. 2011;32(6):616–22.CrossRefPubMed Marmor M, Hansen E, Han H, Buckley J, Matityahu A. Limitations of standard fluoroscopy in detecting rotational malreduction of the syndesmosis in an ankle fracture model. Foot Ankle Int. 2011;32(6):616–22.CrossRefPubMed
19.
Zurück zum Zitat Shah A, Kadakia A, Tan G, Karadsheh M, Wolter T, Sabb B. Radiographic evaluation of the normal distal tibiofibular syndesmosis. Foot Ankle Int. 2012;33(10):870–6.CrossRefPubMed Shah A, Kadakia A, Tan G, Karadsheh M, Wolter T, Sabb B. Radiographic evaluation of the normal distal tibiofibular syndesmosis. Foot Ankle Int. 2012;33(10):870–6.CrossRefPubMed
20.
Zurück zum Zitat Harper M. An anatomic and radiographic investigation of the tibiofibular clear space. Foot Ankle. 1993;14(8):455–8.CrossRefPubMed Harper M. An anatomic and radiographic investigation of the tibiofibular clear space. Foot Ankle. 1993;14(8):455–8.CrossRefPubMed
21.
Zurück zum Zitat Nielson JH, Gardner MJ, Peterson MG, Sallis JG, Potter HG, Helfet DL, Lorich DG. Radiographic measurements do not predict syndesmotic injury in ankle fractures: an MRI study. Clin Orthop Relat Res. 2005;436:216–21.CrossRef Nielson JH, Gardner MJ, Peterson MG, Sallis JG, Potter HG, Helfet DL, Lorich DG. Radiographic measurements do not predict syndesmotic injury in ankle fractures: an MRI study. Clin Orthop Relat Res. 2005;436:216–21.CrossRef
22.
Zurück zum Zitat Hermans JJ, Wentink N, Beumer A, Hop WC, Heijboer MP, Moonen AF, Ginai AZ. Correlation between radiological assessment of acute ankle fractures and syndesmotic injury on MRI. Skeletal Radiol. 2012;41(7):787–801.CrossRefPubMed Hermans JJ, Wentink N, Beumer A, Hop WC, Heijboer MP, Moonen AF, Ginai AZ. Correlation between radiological assessment of acute ankle fractures and syndesmotic injury on MRI. Skeletal Radiol. 2012;41(7):787–801.CrossRefPubMed
23.
Zurück zum Zitat Takao M, Ochi M, Oae K, Naito K, Uchio Y. Diagnosis of a tear of the tibiofibular syndesmosis. The role of arthroscopy of the ankle. J Bone Joint Surg Br. 2003;85(3):324–9.CrossRefPubMed Takao M, Ochi M, Oae K, Naito K, Uchio Y. Diagnosis of a tear of the tibiofibular syndesmosis. The role of arthroscopy of the ankle. J Bone Joint Surg Br. 2003;85(3):324–9.CrossRefPubMed
24.
Zurück zum Zitat Marmor M, Kandemir U, Matityahu A, Jergesen H, McClellan T, Morshed S. A method for detection of lateral malleolar malrotation using conventional fluoroscopy. J Orthop Trauma. 2013;27(12):e281-284.CrossRefPubMed Marmor M, Kandemir U, Matityahu A, Jergesen H, McClellan T, Morshed S. A method for detection of lateral malleolar malrotation using conventional fluoroscopy. J Orthop Trauma. 2013;27(12):e281-284.CrossRefPubMed
25.
Zurück zum Zitat Chang S, Li H, Hu S, Du S, Zhang L, Xiong W. A reliable method for intraoperative detection of lateral malleolar malrotation using conventional fluoroscopy. Injury. 2019;50(11):2108–12.CrossRefPubMed Chang S, Li H, Hu S, Du S, Zhang L, Xiong W. A reliable method for intraoperative detection of lateral malleolar malrotation using conventional fluoroscopy. Injury. 2019;50(11):2108–12.CrossRefPubMed
26.
Zurück zum Zitat Kuo C, Lu H, Lu T, Lin C, Leardini A, Kuo M, et al. Effects of positioning on radiographic measurements of ankle morphology: a computerized tomography-based simulation study. Biomed Eng Online. 2013;12:131.CrossRefPubMedPubMedCentral Kuo C, Lu H, Lu T, Lin C, Leardini A, Kuo M, et al. Effects of positioning on radiographic measurements of ankle morphology: a computerized tomography-based simulation study. Biomed Eng Online. 2013;12:131.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Ha A, Porrino J, Chew F. Radiographic pitfalls in lower extremity trauma. AJR Am J Roentgenol. 2014;203(3):492–500.CrossRefPubMed Ha A, Porrino J, Chew F. Radiographic pitfalls in lower extremity trauma. AJR Am J Roentgenol. 2014;203(3):492–500.CrossRefPubMed
28.
Zurück zum Zitat Mukhopadhyay S, Metcalfe A, Guha A, Mohanty K, Hemmadi S, Lyons K, et al. Malreduction of syndesmosis–are we considering the anatomical variation? Injury. 2011;42(10):1073–6.CrossRefPubMed Mukhopadhyay S, Metcalfe A, Guha A, Mohanty K, Hemmadi S, Lyons K, et al. Malreduction of syndesmosis–are we considering the anatomical variation? Injury. 2011;42(10):1073–6.CrossRefPubMed
29.
Zurück zum Zitat Rammelt S, Boszczyk A. Computed tomography in the diagnosis and treatment of ankle fractures: a critical analysis review. JBJS Rev. 2018;6(12): e7.CrossRefPubMed Rammelt S, Boszczyk A. Computed tomography in the diagnosis and treatment of ankle fractures: a critical analysis review. JBJS Rev. 2018;6(12): e7.CrossRefPubMed
30.
Zurück zum Zitat Brinch S, Wellenberg R, Boesen M, Maas M, Johannsen F, Nybing J, et al. Weight-bearing cone-beam CT: the need for standardised acquisition protocols and measurements to fulfill high expectations-a review of the literature. Skeletal Radiol. 2023;52(6):1073–88.CrossRefPubMed Brinch S, Wellenberg R, Boesen M, Maas M, Johannsen F, Nybing J, et al. Weight-bearing cone-beam CT: the need for standardised acquisition protocols and measurements to fulfill high expectations-a review of the literature. Skeletal Radiol. 2023;52(6):1073–88.CrossRefPubMed
31.
Zurück zum Zitat Lintz F, Beaudet P, Richardi G, Brilhault J. Weight-bearing CT in foot and ankle pathology. Orthop Traumatol Surg Res. 2021;107(1S):102772.CrossRefPubMed Lintz F, Beaudet P, Richardi G, Brilhault J. Weight-bearing CT in foot and ankle pathology. Orthop Traumatol Surg Res. 2021;107(1S):102772.CrossRefPubMed
32.
Zurück zum Zitat Conti M, Ellis S. Weight-bearing CT scans in foot and ankle surgery. J Am Acad Orthop Surg. 2020;28(14):e595–603.CrossRefPubMed Conti M, Ellis S. Weight-bearing CT scans in foot and ankle surgery. J Am Acad Orthop Surg. 2020;28(14):e595–603.CrossRefPubMed
33.
Zurück zum Zitat Prior C, Widnall J, Rehman A, Weller D, Wood E. A simplified, validated protocol for measuring fibular reduction on ankle CT. Foot Ankle Surg. 2017;23(1):53–6.CrossRefPubMed Prior C, Widnall J, Rehman A, Weller D, Wood E. A simplified, validated protocol for measuring fibular reduction on ankle CT. Foot Ankle Surg. 2017;23(1):53–6.CrossRefPubMed
34.
Zurück zum Zitat Burssens A, Peeters J, Peiffer M, Marien R, Lenaerts T, WBCT ISG, et al. Reliability and correlation analysis of computed methods to convert conventional 2D radiological hindfoot measurements to a 3D setting using weightbearing CT. Int J Comput Assist Radiol Surg. 2018;13(12):1999–2008.CrossRefPubMed Burssens A, Peeters J, Peiffer M, Marien R, Lenaerts T, WBCT ISG, et al. Reliability and correlation analysis of computed methods to convert conventional 2D radiological hindfoot measurements to a 3D setting using weightbearing CT. Int J Comput Assist Radiol Surg. 2018;13(12):1999–2008.CrossRefPubMed
35.
Zurück zum Zitat Vasarhelyi A, Lubitz J, Gierer P, Gradl G, Rösler K, Hopfenmüller W, et al. Detection of fibular torsional deformities after surgery for ankle fractures with a novel CT method. Foot Ankle Int. 2006;27(12):1115–21.CrossRefPubMed Vasarhelyi A, Lubitz J, Gierer P, Gradl G, Rösler K, Hopfenmüller W, et al. Detection of fibular torsional deformities after surgery for ankle fractures with a novel CT method. Foot Ankle Int. 2006;27(12):1115–21.CrossRefPubMed
36.
Zurück zum Zitat Nault M, Hébert-Davies J, Laflamme G, Leduc S. CT scan assessment of the syndesmosis: a new reproducible method. J Orthop Trauma. 2013;27(11):638–41.CrossRefPubMed Nault M, Hébert-Davies J, Laflamme G, Leduc S. CT scan assessment of the syndesmosis: a new reproducible method. J Orthop Trauma. 2013;27(11):638–41.CrossRefPubMed
37.
Zurück zum Zitat Dikos G, Heisler J, Choplin R, Weber T. Normal tibiofibular relationships at the syndesmosis on axial CT imaging. J Orthop Trauma. 2012;26(7):433–8.CrossRefPubMed Dikos G, Heisler J, Choplin R, Weber T. Normal tibiofibular relationships at the syndesmosis on axial CT imaging. J Orthop Trauma. 2012;26(7):433–8.CrossRefPubMed
38.
Zurück zum Zitat Knops S, Kohn M, Hansen E, Matityahu A, Marmor M. Rotational malreduction of the syndesmosis: reliability and accuracy of computed tomography measurement methods. Foot Ankle Int. 2013;34(10):1403–10.CrossRefPubMed Knops S, Kohn M, Hansen E, Matityahu A, Marmor M. Rotational malreduction of the syndesmosis: reliability and accuracy of computed tomography measurement methods. Foot Ankle Int. 2013;34(10):1403–10.CrossRefPubMed
39.
40.
Zurück zum Zitat Kubik J, Rollick N, Bear J, Diamond O, Nguyen J, Kleeblad L, et al. Assessment of malreduction standards for the syndesmosis in bilateral CT scans of uninjured ankles. Bone Joint J. 2021;103-B(1):178–83.CrossRefPubMed Kubik J, Rollick N, Bear J, Diamond O, Nguyen J, Kleeblad L, et al. Assessment of malreduction standards for the syndesmosis in bilateral CT scans of uninjured ankles. Bone Joint J. 2021;103-B(1):178–83.CrossRefPubMed
Metadaten
Titel
Radiologic evaluation of ankle fracture malunions of the fibula
verfasst von
Sam Si-Hyeong Park
Timothy L. Miao
Ali Naraghi
Dorota Linda
Lawrence M. White
Publikationsdatum
06.04.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-024-04663-x

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.