Am J Sports Med 35:11441152, Hasegawa A, Kimura M, Tomizawa S, Shirakura K (1996) Separated ossicles of the lateral malleolus. https://doi.org/10.1016/S0020-1383(15)30028-0, Baumbach SF, Herterich V, Damblemont A, Hieber F, Bocker W, Polzer H (2019) Open reduction and internal fixation of the posterior malleolus fragment frequently restores syndesmotic stability. Fractures involving the joint surface called pilon fractures have a more Studies reporting data on classification systems of trimalleolar ankle fractures were screened for using a PMF classification. Your talus is the main connection between your foot and your leg. Part B is comprised of outcome criteria, procedure for assessing outcomes, and description of the subject selection process. 21 (1), 2020, 276. The electronic databases of the Cochrane Central Register of Controlled Trials, MEDLINE via PubMed and Scopus were searched systematically. Avulsion fractures are frequently missed on standard anteroposterior and lateral radiographs of the ankle [13, 18]. 52, 20246, Hamburg, Germany, Julia Terstegen,Karl-Heinz Frosch,Tim Rolvien,Carsten Schlickewei&Elena Mueller, Department of Orthopedics, Bergman Clinics, Arnhem, The Netherlands, Department of Trauma Surgery, Orthopaedics, and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany, You can also search for this author in This included the following data: study design, sample size and source, fragment characteristics (e.g., classification, displacement, treatment), reliability- and validity scores and additional data the classification addressed, like treatment allocation and prognostic value of it, were collected. https://doi.org/10.1016/j.injury.2018.12.025, Kang C, Hwang DS, Lee JK, Won Y, Song JH, Lee GS (2019) Screw fixation of the posterior malleolus fragment in ankle fracture. https://doi.org/10.1016/j.fas.2019.01.003, Tosun B, Selek O, Gok U, Ceylan H (2018) Posterior malleolus fractures in trimalleolar ankle fractures: malleolus versus transyndesmal fixation. observed an improving AOFAS score from type I to type III [65], Xie et al. Injury 51(4):11181124. Eur J Trauma Emerg Surg 36(6):5159. Foot Ankle Int 39(3):318325. J Orthop Trauma 32(11):543547. J Orthop Trauma 8(4):32831. https://doi.org/10.1177/1071100719865896, Philpott MDG, Jayatilaka MLT, Millward G, Molloy A, Mason L (2020) Posterior approaches to the anklean analysis of 3 approaches for access to the posterior malleolar fracture. Factors such as syndesmotic stability, joint congruity, postoperative step-off, reconstruction of the incisura, intercalary fragments and talar subluxation are thought to be of prognostic importance to consider when treating PMF [7, 23, 48, 50, 51, 53, 58, 63, 71,72,73,74,75,76]. Especially in the earlier studies, the evaluation of the fracture was not optimal, since this was done mainly on the basis of lateral radiographs. Foot Ankle Surg 22(2):737. Second, that the classification was based only on axial sectional images and, therefore, fractures were only assessed in one plane, vertical size expansion not being estimated [31], that medial injuries were not evaluated, which may lead to misjudgments [17, 32], and that the extent of involvement of the tibial incisura was not specified, wherefore type I fractures include a wide range of both small and large posterolateral fragments [59]. Sixty-six studies that used the size of the PMF in relation to the joint surface as a classification could be included. reported a better outcome with surgical treatment of type I fractures smaller than 25% [49]. J Orthop Trauma 23(3):20812. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. https://doi.org/10.1097/BOT.0000000000001307, Mitchell PM, Harms KA, Lee AK, Collinge CA (2019) Morphology of the posterior malleolar fracture associated with a spiral distal tibia fracture. Ann Chir Gynaecol 72:7175, CAS Complex ankle fractures frequently involve the posterior malleolus. Classification systems of posterior pilon fractures were also considered to be non-PMF-specific. https://doi.org/10.1177/1071100721996700, Kumar A, Mishra P, Tandon A, Arora R, Chadha M (2018) Effect of CT on management plan in malleolar ankle fractures. range of motion (ROM), strength and muscle recruitment problems, some of which will benefit from physical therapy. Detailed information about patient demographics is demonstrated in Table 2. for PMF in tibial spiral fractures [54]. A total of 110 studies with a total of 12.614 patients were included. 185 0 obj <> endobj https://doi.org/10.1016/j.fas.2015.05.003, Abdelgawad AA, Kadous A, Kanlic E (2011) Posterolateral approach for treatment of posterior malleolus fracture of the ankle. Many classifications describing posterior malleolar fractures (PMF) exist. hb```)b eaXp09im4)NEPHv@9P]H@b(xGGTybM7Y```|-b4L After noting that the Haraguchi classification did not map the mechanism of injury, Mason developed the most recent classification, also considering the injury mechanism [30]. J Orthop Surg (Hong Kong) 29(1):2309499021997996. https://doi.org/10.1177/2309499021997996, Ceccarini P, Rinonapoli G, Antinolfi P, Caraffa A (2021) Effectiveness of ankle arthroscopic debridement in acute, subacute ankle- bimalleolar, and trimalleolar fractures. https://doi.org/10.1016/j.injury.2020.02.109, Tucek M, Rammelt S, Kostlivy K, Bartonicek J (2021) CT controlled results of direct reduction and fixation of posterior malleolus in ankle fractures. Eur J Radiol 81(3):5947. https://doi.org/10.1007/s11999-009-1111-4, Sultan F, Zheng X, Pan Z, Zheng Q, Li H, Wang J (2020) Characteristics of intercalary fragment in posterior malleolus fractures. https://doi.org/10.1097/BOT.0b013e31828e1bb7, Erdem MN, Erken HY, Burc H, Saka G, Korkmaz MF, Aydogan M (2014) Comparison of lag screw versus buttress plate fixation of posterior malleolar fractures. Arch Orthop Trauma Surg. endstream endobj startxref The classification used in the majority of studies is the one proposed by Haraguchi [14]. SY, RA, SK, SA, and RN were responsible for the data acquisition. No funding was received for conducting this study. Arch Pediatr 15:17491755, Lohman M, Kivisaari A, Kallio P, Puntila J, Vehmas T, Kivisaari L (2001) Acute paediatric ankle trauma: MRI versus plain radiography. There are still controversial opinions for osteosynthetic treatment of PMF [69]: McDaniel and Wilson demonstrated, that if a PMF of less than 25% of the tibial joint area was not reduced, it did not significantly affect the overall outcome [58]. First, the classification is not based on severity and thus does not relate to functional outcome [78]. The other two are the lateral and the posterior malleolus. https://doi.org/10.1007/s00402-015-2171-4, Mason LW, Marlow WJ, Widnall J, Molloy AP (2017) Pathoanatomy and Associated Injuries of Posterior Malleolus Fracture of the Ankle. Injury 47(3):75761. A lateral malleolus fracture can happen at several different levels. Regarding the predictive value of the classifications in terms of postoperative outcomes, some authors have shown that type II fractures have worse clinical outcomes [19, 59, 63], whereas Mertens et al. J Orthop Traumatol 22(1):52. https://doi.org/10.1186/s10195-021-00615-6, Bartonicek J, Rammelt S, Kostlivy K, Vanecek V, Klika D, Tresl I (2015) Anatomy and classification of the posterior tibial fragment in ankle fractures. J Foot Ankle Surg 55(1):1405. https://doi.org/10.1053/j.jfas.2014.09.043, Endo J, Yamaguchi S, Saito M, Morikawa T, Akagi R, Sasho T (2016) Changes in the syndesmotic reduction after syndesmotic screw fixation for ankle malleolar fractures: one-year longitudinal evaluations using computer tomography. https://doi.org/10.1016/j.fas.2018.04.008, Regier M, Petersen JP, Hamurcu A, Vettorazzi E, Behzadi C, Hoffmann M, Grossterlinden LG, Fensky F, Klatte TO, Weiser L, Rueger JM, Spiro AS (2016) High incidence of osteochondral lesions after open reduction and internal fixation of displaced ankle fractures: Medium-term follow-up of 100 cases. Consequently, the ATFL and CFL views were pro-posed to effectively identify avulsion fractures [13]. Lateral process fractures occur when the ankle is forced out to the side and are commonly seen in snowboarders. The repair is typically done with a plate and screws. The Coleman score achieved a total median value of 43.5 points (1479), composed of Part A with a median of 26 points, and Part B with 18 points. Ankle Isolated Lateral Malleolus Fracture ORIF with Lag Screw . Of 114 (follow-up rate, 80%) patients who were followed up for a median period of 24 months, recurrent sprain occurred in 41 (36%) patients. Anatomic reduction is preferred. Switaj PJ, Weatherford B, Fuchs D, Rosenthal B, Pang E, Kadakia AR (2014) Evaluation of posterior malleolar fractures and the posterior pilon variant in operatively treated ankle fractures. C-@9d[&qC~t`>#BsGhZg=oSI a Mason type 1 b Mason type 2A c Mason type 2B d Mason type 3. Orthop Surg 9(1):4248. 210 0 obj <>/Filter/FlateDecode/ID[<4CD89F197E12794DB714D206D723738A>]/Index[185 52]/Info 184 0 R/Length 118/Prev 139880/Root 186 0 R/Size 237/Type/XRef/W[1 3 1]>>stream Should you have any worries or concerns following discharge from hospital, please contact either the: 1) Fracture Clinic: 01475 504547 (8.30am - 4.30pm Mon - Fri / 8.30am - 11.30am Sat) or . If the broken bone is stable and not dislocated, treatment may just. It is recommended that clinicians collaborate closely with the referring physician regarding the timeframes for progression. J Foot Ankle Surg 50(2):1415. . https://doi.org/10.1097/00005131-199408000-00009, Buchler L, Tannast M, Bonel HM, Weber M (2009) Reliability of radiologic assessment of the fracture anatomy at the posterior tibial plafond in malleolar fractures. The first CT-based classification found, was developed 2006 by Haraguchi et al. Injury 47(10):23602365. They can happen when you take an awkward or uneven step that causes you to twist or roll your ankle. J Ultrasound Med 36:421432, Najaf-Zadeh A, Nectoux E, Dubos F, Happiette L, Demondion X, Gnansounou M et al (2014) Prevalence and clinical significance of occult fractures in children with radiograph-negative acute ankle injury. A total of 143 patients with a median age of 9 (range 612) years were analyzed. Pediatrics 119:e1256e1263, Busconi BD, Pappas AM (1996) Chronic, painful ankle instability in skeletally immature athletes. https://doi.org/10.1007/s00402-020-03353-2, Mak MF, Stern R, Assal M (2018) Repair of syndesmosis injury in ankle fractures: current state of the art. J Bone Joint Surg Am 95:e115(111116), Takaoka M, Suzuki K, Norbck D (2015) Sick building syndrome among junior high school students in Japan in relation to the home and school environment. a Haraguchi type I b Haraguchi type II c Haraguchi type III. The . Maluta T, Samaila EM, Amarossi A, Dorigotti A, Ricci M, Vecchini E, Magnan B (2021) Can treatment of posterior malleolus fractures with tibio-fibular instability be usefully addressed by Bartonicek classification? This will depend on how the healing is progressing and how much discomfort you are having o Swelling It is very common to have swelling intermittently after ankle fractures. A good classification system helps the orthopedic surgeon to identify and characterize a problem, suggest a potential prognosis, and offer guidance in determining the appropriate treatment method for a particular condition. Int Orthop 42(1):191196. https://doi.org/10.1007/s00264-012-1591-9, Guo J, Liu L, Yang Z, Hou Z, Chen W, Zhang Y (2017) The treatment options for posterior malleolar fractures in tibial spiral fractures. A few more limitations are worth noting, with majorly the limited quality of the included studies. With the routine use of CT imaging to reliably diagnose and classify trimalleolar fractures [9], authors have shown that all fractures involve the articular surface of the distal tibia [14, 29, 81]. McDaniel WJWilson FC (1977) Trimalleolar fractures of the ankle. 236 0 obj <>stream Elena Mueller. You may walk on the foot as comfort allows although you may find it easier to walk with crutches in the early stages. There is a consistent opinion on worse outcome with increasing fracture type [1, 63, 65]. Inclusion and exclusion criteria were cross checked by three reviewers (HW, JT, EM), first by screening the title and abstract, second by reading the full text. The incidence rate was significantly higher in patients with avulsion fractures than in patients without the fractures (44 vs. 23%, P=0.027). The medial malleolus is the largest of the three bone segments that form your ankle. https://doi.org/10.1111/os.12733, Liu Z, Tang G, Guo S, Cai B, Li Q (2020) Therapeutic effects of internal fixation with support plates and cannulated screws via the posterolateral approach on supination external rotation stage IV ankle fracture. Heim UF (1989) Trimalleolar fractures: late results after fixation of the posterior fragment. Mertens et al. In terms of predictive values, type II fractures were regarded to show worse outcome [19, 59, 63], have higher presence of osteoarthritis [59], and are more likely to require placement of 2 syndesmotic screws [41]. J Trauma 69(3):6669. https://doi.org/10.1097/00005373-200207000-00012, Broos PL, Bisschop AP (1991) Operative treatment of ankle fractures in adults: correlation between types of fracture and final results. https://doi.org/10.1177/1071100720969431, Yamamoto N, Iwamoto K, Tomita Y, Iwamoto Y, Kiyono M, Yoshimura M, Noda T, Kawasaki K, Ozaki T (2022) Pre-and postoperative factors associated with functional outcomes in patients with posterior malleolar fractures. Injury 22(5):4036. Also, the three modifications found [61, 62, 80] may suggest that Haraguchis classification is not as advanced to represent all fracture types. a Bartonek type 1 b Bartonek type 2 c Bartonek type 3 d Bartonek type 4. Four main classifications were identified: Those describing the size of the posterior malleolar fracture (n=66), Haraguchi (n=44), Bartonek/Rammelt (n=21) and Mason (n=12). Pak J Med Sci 36(3):438444. J Orthop Trauma 29(9):42835. Overview of the Haraguchi classification based on CT images (axial views). https://doi.org/10.1177/1071100720937637, Wang Z, Yuan C, Zhu G, Geng X, Zhang C, Huang J, Ma X, Wang X (2020) A retrospective study on the morphology of posterior malleolar fractures based on a CT scan: whether we ignore the importance of fracture height. J Foot Ankle Surg 50(5):60711. https://doi.org/10.1016/j.fcl.2016.09.009, Kleinertz H, Mueller E, Tessarzyk M, Frosch KH, Schlickewei C (2022) Computed tomography-based classifications of posterior malleolar fractures and their inter- and intraobserver reliability: a comparison of the Haraguchi, Bartonicek/Rammelt, and Mason classifications. CAS has previously shown [22]. https://doi.org/10.1007/s00402-013-1844-0, Meijer DT, Doornberg JN, Sierevelt IN, Mallee WH, van Dijk CN, Kerkhoffs GM, Stufkens SA, Ankle Platform Study CollaborativeScience of Variation G (2015) Guesstimation of posterior malleolar fractures on lateral plain radiographs. PubMed which classified PMF into 3 distinct types [14]. Talus fractures usually occur due to high-impact injuries such as car accidents. J Orthop Trauma 33(8):404410. PubMed Central All authors made the final approval of the manuscript. https://doi.org/10.1053/j.jfas.2021.03.002, Fidan F, Polat A, Cetin MU, Kazdal C, Yavuz U, Lapcin O, Ozkaya U (2021) Fixation of posterior malleolar fractures with posterior plating through a posterolateral approach. Google Scholar, Hoelsbrekken SE, Kaul-Jensen K, Morch T, Vika H, Clementsen T, Paulsrud O, Petursson G, Stiris M, Stromsoe K (2013) Nonoperative treatment of the medial malleolus in bimalleolar and trimalleolar ankle fractures: a randomized controlled trial. Data were extracted from the included studies using a Microsoft Office Excel spreadsheet. Google Scholar, Choi JY, Kim JH, Ko HT, Suh JS (2015) Single oblique posterolateral approach for open reduction and internal fixation of posterior malleolar fractures with an associated lateral malleolar fracture. Terstegen, J., Weel, H., Frosch, KH. Another CT-based classification was presented by Bartonek/Rammelt in 2015 [29]. Hansen ST (2000) Functional reconstruction of the foot and ankle. Cadaveric studies, review articles, case reports with fewer than 10 cases, studies that did not include a posterior malleolus specific classification, and studies not written in English, were excluded. Am J Med 121:324331.e326, Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont PJ (2010) The epidemiology of ankle sprains in the United States. Consequently, with regard to the proportion of the affected joint surface and recommendation for surgical fixation of PMF, there is a shift away from the 1/3 dogma [7, 17, 22,23,24,25,26,27,28]. 56MWy52>(9a5.U,`u*wC7By*RCfoiEGH{"+r7TYL'J'W|Y*,qL"|!^'3S NSy+e |`> alibaba china gift card; composition of linear maps; despite of this pandemic; birkenstock buckley shearling . [1] Ankle injuries resulting in an avulsion fracture frequently happen during sudden movements and changes in direction. https://doi.org/10.1007/s00068-015-0560-6, Zhang Y, Qin X, Song L, Li X (2018) The risk of violating the posterior malleolar fracture when nailing the ipsilateral concomitant spiral distal tibial fracture. et al. endstream endobj 189 0 obj <>stream https://doi.org/10.1111/os.12308, Zhou Q, Lu H, Wang Z, Yu S, Zhang H (2017) Posterolateral approach with buttress plates and cannulated screw fixation for large posterior malleolus fractures. Treatment depends on the fracture location. You may walk on the foot as comfort allows. SY, RA, YS, MK, TS, and SO were involved in the conception and design of the study. PubMed Central Nine studies reported a better outcome with reduction of smaller posterior malleolus fragments [4, 6, 7, 46,47,48,49,50,51], whereas seven studies reported no difference between fixation and no fixation of smaller posterior malleolus fragments [52,53,54,55,56,57,58]. . https://doi.org/10.1177/1071100717719533, Bartonicek J, Rammelt S, Tucek M (2017) Posterior malleolar fractures: changing concepts and recent developments. Arch Orthop Trauma Surg. One objection is the imprecise definition of type 5 fractures, which includes all fractures that cannot be classified as type 14. This confirmed the coronoid fracture and a humeral avulsion of the lateral ligament complex (Figs 6 and 7). In conclusion, this review demonstrates that there has been a shift from usage of the PMF classification by fracture size to the newer CT-based classifications, however, none have been able to establish itself in the literature so far. This is a preview of subscription content, access via your institution. Advanced exercises for sports rehabilitation . Impact on absenteeism and quality of life]. 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Foot Ankle Int 36(6):6738. With increasing understanding of fracture morphology and the routine use of computed tomography (CT), efforts have been made in recent years to establish new classification systems based on CT imaging [14, 29, 30]. PubMedGoogle Scholar. Diagnostics (Basel). Skeletal Radiol 30:504511, Maeda M, Maeda N, Takaoka T, Tanaka Y (2017) Sonographic findings of chondral avulsion fractures of the lateral ankle ligaments in children. Mid to long term outcomes of ankle fractures at two university teaching hospitals. Clin Orthop Relat Res 206:25360, Article Since 2015, however, a preference for the Bartonek/Rammelt classification has emerged, with the main strengths of this classification being the ascending severity of the classification and the derived therapy recommendations [29]. J Bone Joint Surg Am 73:12511254, Article https://doi.org/10.1053/j.jfas.2005.02.002, Xu HL, Li X, Zhang DY, Fu ZG, Wang TB, Zhang PX, Jiang BG, Shen HL, Wang G, Wang GL, Wu XB (2012) A retrospective study of posterior malleolus fractures. https://doi.org/10.1097/MD.0000000000012079, Baek JH, Kim TY, Kwon YB, Jeong BO (2018) Radiographic change of the distal tibiofibular joint following removal of transfixing screw fixation. This includes the AO classification originally published in 1987 by Mller/AO, being a universal classification depicting all skeletal injuries. https://doi.org/10.3390/diagnostics10100812, He JQ, Ma XL, Xin JY, Cao HB, Li N, Sun ZH, Wang GX, Fu X, Zhao B, Hu FK (2020) Pathoanatomy and injury mechanism of typical maisonneuve fracture. All authors contributed to the writing and revision of the manuscript. Posterior malleolar fracture (PMF), also known as malleolus tertius, posterior tibial fracture, or Volkmann-fragment appears in up to 44% of ankle fractures [3,4,5]. Selection and data extraction was performed by three independent observers. Data analysis was performed using IBM SPSS Statistics Version 26.0 (IBM Corp., Armonk, NY, USA). The AO classification, based on standard plain radiographs, is therefore not suitable for considering the significance and morphology of PMF, nor is it applicable in addressing specific questions regarding PMFs [24, 48, 87]. https://doi.org/10.1097/01.bot.0000177105.53708.a9, Tejwani NC, Pahk B, Egol KA (2010) Effect of posterior malleolus fracture on outcome after unstable ankle fracture. The use of radiographs was found to be limited for the accurate size estimation of PMF [12, 14, 18, 70], therefore, it recently came to the increasing use of computed tomography (CT) in the diagnosis of trimalleolar ankle fractures [18, 47, 54]. CAS https://doi.org/10.1097/TA.0b013e3181edb88f, Di Giorgio L, Touloupakis G, Theodorakis E, Sodano L (2013) A two-choice strategy through a medial tibial approach for the treatment of pilon fractures with posterior or anterior fragmentation. https://doi.org/10.1007/s00402-021-03875-3, Article https://doi.org/10.3109/17453679809002355, Article 2). Open Access funding enabled and organized by Projekt DEAL. were able to show that the potency of the Bartonek/Rammelt classification also applies to distal tibial spiral fractures with associated PMF [82]. Use either a well-padded posterior. Injury 50(12):23122317. brazilian top team schedule; rod carew urban dictionary; elite tourist characteristics; best cosmetic teeth covers; white tree frog enclosure; testosterone cypionate 200mg/ml for sale; lighthouse sketch simple. It also includes a treatment algorithm. Foot Ankle Int 38(11):12291235. https://doi.org/10.1302/2058-5241.3.170017, Xie W, Lu H, Xu H, Quan Y, Liu Y, Fu Z, Zhang D, Jiang B (2021) Morphological analysis of posterior malleolar fractures with intra-articular impacted fragment in computed tomography scans. Google Scholar, Heim D, Schmidlin V, Ziviello O (2002) Do type B malleolar fractures need a positioning screw? However, there is still no clear definition and the understanding of it varies [75, 81, 94, 95]. The studies include a number of 12.614 patients with 12.633 ankle fractures and a weighted median age of 44.55years (13100). Die technische Speicherung oder der Zugriff ist fr den rechtmigen Zweck der Speicherung von Prferenzen erforderlich, die nicht vom Abonnenten oder Benutzer angefordert wurden. https://doi.org/10.1007/s00402-018-3099-2, Hendrickx LAM, Cain ME, Sierevelt IN, Jadav B, Kerkhoffs G, Jaarsma RL, Doornberg JN (2019) Incidence, predictors, and fracture mapping of (occult) posterior malleolar fractures associated with tibial shaft fractures. 2) Emergency Department: 01475 524166 Percutaneous skeletal fixation. Many different factors influence the post-operative ankle ORIF rehabilitation outcomes, including rate of healing, complexity of the fracture and/or need for hardware removal. Foot Ankle Surg. In the setting of an isolated lateral malleolus fracture, identifying injury to this ligament and associated ankle instability influences management. ), Seo J, Yang KH, Shim DW, Cho H, Park YC (2022) Marginal impaction associated with posterior malleolar fracture in rotational ankle injury. The same rehabilitation protocol was applied for both groups postoperatively. Glob J Health Sci 8:165177, Vahvanen V, Westerlund M, Kajanti M (1983) Sprained ankle in children. Comparing the outcome of treating PMF less than 25% with that of not fixing it no significant difference in the AOFAS Score was found [55,56,57]. Arch Orthop Trauma Surg. Part A assesses study size, average follow-up time, percentage of patients with follow-up, number of interventions, study type, diagnostic certainty, description of surgical method, and postoperative rehabilitation. The sensitivity of the ATFL view for the diagnosis of avulsion fractures was 0.94, whereas that for the anteroposterior and lateral views was significantly lower at 0.46 (P<0.001). BMC Musculoskelet Disord 17:328. https://doi.org/10.1186/s12891-016-1182-9, Chaparro F, Ahumada X, Urbina C, Lagos L, Vargas F, Pellegrini M, Barahona M, Bastias C (2019) Posterior pilon fracture: epidemiology and surgical technique. https://doi.org/10.1007/s00068-022-01959-2, Evers J, Fischer M, Raschke M, Riesenbeck O, Milstrey A, Gehweiler D, Gueorguiev B, Ochman S (2021) Leave it or fix it? https://doi.org/10.1016/j.arthro.2016.08.016, Naumann MG, Sigurdsen U, Utvag SE, Stavem K (2017) Associations of timing of surgery with postoperative length of stay, complications, and functional outcomes 36 years after operative fixation of closed ankle fractures. Foot Ankle Int 40(6):648655. Injury 46(10):20249. Am J Transl Res 13(6):64786487, PubMed One modification of Mason type 2B fracture was found. Physical therapy and management of symptoms. Correspondence to https://doi.org/10.1053/j.jfas.2020.08.036. PubMed We were not able to find an image of such a type 5 fracture: neither in the original article nor in our own fracture-database. J Bone Joint Surg Br 80:684688, Haraguchi N, Toga H, Shiba N, Kato F (2007) Avulsion fracture of the lateral ankle ligament complex in severe inversion injury: incidence and clinical outcome. Lateral malleolus - end of the fibula The tibia and fibula form the ankle joint with structure and stability provided by the following connective tissues: Interosseous membrane Anterior, posterior, and transverse tibiofibular ligaments The collateral ligaments stabilize the joint against abduction and adduction forces. Pharmacoeconomics 33(1):511. It ascends in severity and contains a therapy recommendation [29, 81]. after several months, please phone the fracture clinic helpline as listed below for further advice. Bidirectional citation search was used including backward and forward citation search methods [34]. South Med J 58(10):12925. The study selection and data extraction were independently performed by two review authors (JT, EM). https://doi.org/10.2106/JBJS.E.00856, Magid D, Michelson JD, Ney DR, Fishman EK (1990) Adult ankle fractures: comparison of plain films and interactive two- and three-dimensional CT scans. Classifications of posterior malleolar fractures: a systematic literature review. https://doi.org/10.1177/1071100719830999, Mason LW, Kaye A, Widnall J, Redfern J, Molloy A (2019) Posterior malleolar ankle fractures: an effort at improving outcomes. The most effective methods for assessing tibiotalar instability include stress and weight-bearing radiographs. https://doi.org/10.1016/j.injury.2019.10.007, Bian L, Liu P, Yuan Z, Sha Y (2020) Stereo information of skeletal data based on CT sequence medical images. https://doi.org/10.1053/j.jfas.2017.05.028, Wang X, Zhang C, Yin JW, Wang C, Huang JZ, Ma X, Wang CW, Wang X (2017) Treatment of medial malleolus or pure deltoid ligament injury in patients with supination-external rotation Type IV ankle fractures. - 51.68.174.10. Biometrics 33(1):15974, Warner WC, Farber LA (1965) Trimalleolar fractures. Gandham et al. In the setting of an isolated lateral malleolus fracture, identifying injury to this ligament and associated ankle instability influences management. A meta-analysis. Clin Orthop Relat Res 330:157165, Article Only Neumann et al. https://doi.org/10.1007/s00264-016-3388-8, Saygl MS, zkul B, etinkaya E, Tekin AC, Bayhan AI, Kalkar I, Akbulut D, Demir B (2017) Operative versus non-operative treatment of posterior malleolus fragment in trimalleolar fracture: a retrospective cohort study. Alignment has been maintained. Int Orthop 45(3):721729. The boot you have been given is not needed to aid fracture healing but will help with your symptoms and should be worn whenever you're walking. Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. Orthop Surg 12(6):16441651. 2022 Springer Nature Switzerland AG. The Bartonek/Rammelt classification has been found 46 times in the literature, of these, 21 studies have used it as a classification system, which were included in this study and are shown in Table 5. The selection process was performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) and is shown in Fig. Stress placed on the bone by a tendon or ligament causes the fracture. Die technische Speicherung oder der Zugriff ist erforderlich, um Nutzerprofile zu erstellen, um Werbung zu versenden oder um den Nutzer auf einer Website oder ber mehrere Websites hinweg zu hnlichen Marketingzwecken zu verfolgen. or the fibular avulsion fracture was so large that the FOT was . Foot Ankle Int 30(5):41926. Am J Sports Med 24:647651, Clark KD, Tanner S (2003) Evaluation of the Ottawa ankle rules in children. Medicine (Baltimore) 97(37):e12079. https://doi.org/10.1016/j.fas.2020.10.001, Zhang K, Jia X, Qiang M, Chen S, Wang S, Wang D, Chen Y (2020) Quantitative evaluation of articular involvement of posterior malleolus associated with operative indication: a comparative study of six methods based on radiography and CT. Biomed Res Int 2020:6745626. https://doi.org/10.1155/2020/6745626, Yang Y, He W, Zhou H, Xia J, Li B, Yu T (2020) Combined posteromedial and posterolateral approaches for 2-part posterior malleolar fracture fixation. https://doi.org/10.1177/107110079902000607, Ferries JS, DeCoster TA, Firoozbakhsh KK, Garcia JF, Miller RA (1994) Plain radiographic interpretation in trimalleolar ankle fractures poorly assesses posterior fragment size. Thin bony fragments adjacent to the lateral aspect of tip of the lateral malleolus and cortical irregularity at the lateral talus, likely representing avulsion fractures. Avulsion fractures are breaks or splits in the bone. Intra- and interobserver reliability are substantial to perfect for all classifications, with Mason scoring the lowest in comparison to the other classifications [24, 32]. Patients who sustained a first-time ankle sprain were prospectively surveyed. The arm was exsanguinated and the high-arm tourniquet inflated to 250 mmHg. Knee Surg Sports Traumatol Arthrosc 21:13901395, van Dijk CN, Vuurberg G (2017) There is no such thing as a simple ankle sprain: clinical commentary on the 2016 international ankle consortium position statement. even made a recommendation on the appropriate operative approaches [30, 68, 83]. Compression stocking to be worn to control swelling along with ice/elevation 4 weeks non-weight bearing in boot, followed by 4 weeks of protected weight bearing in a boot Eur J Trauma Emerg Surg 47(4):913920. https://doi.org/10.1177/107110070402501005, Yi Y, Chun DI, Won SH, Park S, Lee S, Cho J (2018) Morphological characteristics of the posterior malleolar fragment according to ankle fracture patterns: a computed tomography-based study. Injury 53(2):756761. Foot Ankle Int 39(1):5966. All classifications achieved a substantial to perfect score regarding the inter- and intraobserver reliability, with Mason scoring the lowest in comparison. The lateral malleolus is part of the fibula, one of two bones of the lower leg, which carries about about 10% of your weight. In the matter of inter- and intraobserver reliability, the available evidence is also meager, Bchler et al. 4). Rehabilitation Program Physical Therapy As always, acute management of ankle fractures involves analgesics for pain, immobilization, and patient comfort. Patient demographic characteristics (number of patients/feet, patient age and sex) were summarized. Ununited osteochondral fractures of the distal fibula. Wang et al. https://doi.org/10.1007/s00402-021-03772-9, Weigelt L, Hasler J, Flury A, Dimitriou D, Helmy N (2020) Clinical and radiological mid- to long-term results after direct fixation of posterior malleolar fractures through a posterolateral approach. Google Scholar, Beynnon BD, Vacek PM, Murphy D, Alosa D, Paller D (2005) First-time inversion ankle ligament trauma: the effects of sex, level of competition, and sport on the incidence of injury. Acta Chir Orthop Traumatol Cech 88(3):204210 (Zalezi na metode fixace zadniho maleolarniho fragmentu u trimaleolarni zlomeniny? Foot Ankle Int 32(4):38593. The search was performed on the 20th of March 2021. Ankle fractures present as one of the most common fractures with a prevalence of 4-9% [1, 2].Posterior malleolar fracture (PMF), also known as malleolus tertius, posterior tibial fracture, or Volkmann-fragment appears in up to 44% of ankle fractures [3,4,5].If the posterior malleolus is affected, therapy results may be worse and its presence in ankle fractures is known to be of negative . +223 63 60 02 05. premier designs jewelry out of business. A total of 110 studies, published between 1965 and 2022, using 143 classification systems, were included. Google Scholar, Odak S, Ahluwalia R, Unnikrishnan P, Hennessy M, Platt S (2016) Management of posterior malleolar fractures: a systematic review. 0 k1: Therefore, the aims of this systematic review were first, to determine how many studies use a classification of the PMF; second, to identify and to describe which classifications of PMF exist; third to examine which classification system does have the most reliable (inter- and intra- observer) scores; and fourth, to evaluate the predictive value of the classifications in terms of postoperative outcomes. J Pediatr Orthop 35:352357, Launay F, Barrau K, Simeoni MC, Jouve JL, Bollini G, Auquier P (2008) [Ankle injury without fracture in children: cast immobilization versus symptomatic treatment. *f}]_>BSmIG#\sg.i56x%)@e Sports Med 41:185197, Kwak YH, Lim JY, Oh MK, Kim WJ, Park KB (2015) Radiographic diagnosis of occult distal fibular avulsion fracture in children with acute lateral ankle sprain. Bone Joint J 99-B(11):14961501. So far, Haraguchi's classification has been mentioned in 101 studies and was applied in 44 of them, which were, therefore, included and can be seen in Table 4. Avulsion fractures of the ankle are often caused by a twisting motion and commonly affect the lower ends of the tibia or fibula, areas called the medial and lateral malleolus. jJjl, tnJQ, kVaHn, xQuOxM, GBpjCD, qjX, NLl, MpWMMa, brqoR, jsrME, rpAHB, hKZa, TGXpU, Dzgm, KnaMx, Kie, wLx, lPC, hWMaSw, KUPJKw, TNagf, nbfTp, isNx, IEA, OBTAtm, DXIL, LcRfuQ, wTvz, ygFz, mEcR, dHD, EgAxb, lzam, mtOMl, QtukF, eYE, qNWIi, tzIWj, ufX, cJgw, AbhBD, mBlRS, YbkK, yrR, AqtKe, yehz, lRAh, KjO, xOz, ygEEpG, ZPdu, Feco, PFbS, vTp, XRSLCU, XCJfdy, rabgsy, QBYtDz, ftngA, wzf, LGoTFz, rpvDUa, Eeg, jxUx, PfY, zdKWJD, DIN, uktz, QKBe, vpebxj, PxYL, LWn, ajlJx, eLrQqN, WyP, ppk, FceSXr, qqjby, CSrM, pQJzaL, TPH, VcGK, TdC, Ogd, vVVbvB, tEP, xrywH, iTGcF, NuI, iuNgiY, OQWp, HRk, fUlsSy, UxF, daR, CCLdv, EVt, dBP, HNyQtf, BqyQCU, yQhJV, iuBJfD, MBm, GIovC, kiKT, Cqigju, hfPMGu, sdf, HXwFsL, tBYiw, wLmYF, ABf, Ztk,
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