Precise Evaluation of the Reduction of Severe Ankle Fractures

Joy, Gregory; Patzakis, Michael J.; Harvey, J.

doi:10.2106/00004623-197456050-00010

Cited by 196 publications

(113 citation statements)

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“…323 A 1-mm shift generally is considered acceptable, while a 2-mm shift should be surgically corrected because of the high risk of degenerative changes. 203 Apparently, the talar cartilage can adapt to an increase in contact stress as great as 42%. These findings concur with studies on contact stresses caused by OCDs.…”

Section: Cartilage Physiologymentioning

confidence: 99%

Treatment of osteochondral defects of the talus

Bergen

Leeuw

Dijk

2008

Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Mo

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Section: Cartilage Physiologymentioning

confidence: 99%

Treatment of osteochondral defects of the talus

Bergen

Leeuw

Dijk

2008

Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Mo

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“…However, for many reasons, anatomic fracture reduction may not be achieved (Horisberber et al 2009, Luebbeke et al 2012. Failure to reproduce the anatomic relationship of the distal tibia and fibula leads to altered loading of the tibiotalar joint (Ramsay and Hamilton 1976, Thordarson et al 1997, Harris and Fallat 2004, Lloyd et al 2006) and subsequent post-traumatic arthritis (Lindsjö 1981, Pettrone et al 1983, Leeds et al 1984, Lindsjö 1985, Rukavina 1998) with poor functional outcomes (Joy et al 1974, Pettrone et al 1983, Mont et al 1992, Weening et al 2005, Wikerøy et al 2009, Sagi et al 2012. Surgical site infection (SSI) is one of the most common complications following ankle fracture surgery (Shephers et al 2011).…”

Section: Introductionmentioning

confidence: 99%

Complications in ankle fracture surgery

Ovaska¹

2015

Acta Orthopaedica

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“…Tornetta stated that these tests are the gold standard of subluxation, an indirect measurement of deltoid injury or deltoid insuYciency. The amount of medial clear space widening indicative of a positive external rotation stress or gravity-stress test has been somewhat variable in the literature [8,12,16,18,19,21,23,28,29,32,35,40,46]. Normal values reported in the literature have varied from 1 to 5 mm [8,11,19,21,28].…”

Section: Discussionmentioning

confidence: 99%

“…Lauge-Hansen supination external rotation (SER)-type ankle fractures are equivalent to a Weber B injury and account for 40-75% of all ankle fractures [13,20,23,26,30,33,58]. The SER-type fractures are numbered I through IV in order of severity [8].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature

Bekerom

Mutsaerts

Dijk

2008

Arch Orthop Trauma Surg

113

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Background and purpose Review the literature concerning modalities to evaluate the integrity of the deltoid ligament in patients with supination external rotation ankle fractures. Methods The electronic databases Pubmed/Medline, CINAHL and Embase were searched from 1987 to November 2007 to identify all published original studies concerning diagnostic modalities to evaluate the integrity of the deltoid ligament in adult ankle fractures. Results This review included nine studies involving 423 ankle fractures. Three trails investigated medial tenderness; two studies, ecchymosis; two studies, swelling; one study, an injury radiograph; six studies, a type of radiographic stress view; one study, the Lauge-Hansen classiWcation; one study, MRI; and one article studied arthroscopy in the evaluation of the deltoid ligament integrity. Interpretation Swelling, ecchymosis, medial tenderness, initial injury radiographs and the Lauge-Hansen classiWcation are less adequate predictors of the integrity of the deltoid ligament. Manual or the less painful variant, the gravity external rotation stress radiographs are considered the gold standard. The amount of medial clear space widening indicative of a positive external rotation stress test has been somewhat variable in the literature but ¸5 mm is generally regarded as most reliable. Achieving adequate external rotation of the foot when obtaining stress radiographs is more important than positioning the ankle in the appropriate degree of ankle Xexion. The amount of applied force necessary when performing an external rotation stress radiograph is not well deWned and mainly determined by the patient's pain level. The indication for surgery should not be based on the absolute value of one parameter but on the combination of several parameters. If nonoperative treatment is chosen despite a positive stress radiograph, close follow-up is critical because subluxation of the ankle joint is still possible. MRI could be useful in individual cases.

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Precise Evaluation of the Reduction of Severe Ankle Fractures

Cited by 196 publications

References 0 publications

Treatment of osteochondral defects of the talus

Treatment of osteochondral defects of the talus

Complications in ankle fracture surgery

Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature

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