Results of a Computed Tomography Protocol Evaluating Distal Third Tibial Shaft Fractures to Assess Noncontiguous Malleolar Fractures

Purnell, Gregory J.; Glass, Ericka R.; Altman, Daniel T.; Sciulli, Robert L.; Muffly, Matthew T.; Altman, Gregory T.

doi:10.1097/ta.0b013e3181edb88f

Cited by 43 publications

(50 citation statements)

References 17 publications

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“…We believe the reason to be the different characteristics of our study cohort compared to those of previous studies that included direct and crush injuries. [7][8][9] Our study essentially investigated the tibial shaft fractures caused by indirect injury. In this study, we defined ankle injuries as involving the lateral malleolar fracture and distal tibial articular surface and systematically categorized ankle injuries into posterior malleolar and AITFL avulsion fracture.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Ankle Injuries Associated With Tibial Shaft Fractures

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Concomitant Ankle Injuries Associated With Tibial Shaft Fractures

et al. 2015

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“…Two recent studies utilizing CT imaging to evaluate for concomitant ankle fractures demonstrated a higher incidence of injury ranging from 39–43%. 8,10 However, both of these studies limited their investigation to distal one-third diaphyseal tibia fractures. Our results indicate that concomitant articular ankle injuries are more common than previously reported.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, although distal one-third spiral tibial shaft fractures have been shown to have a strong association with concomitant ankle fractures, no publication has explicitly quantified the predictive ability of this, or other, radiographic fracture patterns. 8–10 Therefore, our hypothesis for this study is twofold: 1) the incidence of concomitant ankle injuries and tibial shaft fractures is underappreciated and is higher than previously reported; and 2) common radiographic characteristics such as location and pattern of the tibial and fibular shaft fractures exist that can quantitatively predict the presence or absence of an ankle injury.…”

Section: Introductionmentioning

confidence: 95%

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Predictive Radiographic Markers for Concomitant Ipsilateral Ankle Injuries in Tibial Shaft Fractures

Schottel

Berkes

Little

et al. 2014

Journal of Orthopaedic Trauma

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STRUCTURED ABSTRACT Objectives To quantify the radiographic tibia and fibula shaft fracture characteristics that are associated with a concomitant ipsilateral ankle injury. Design Retrospective case-control study. Setting Academic level I trauma center. Patients Seventy-one adult patients with an operatively treated tibial shaft fracture met the inclusion/exclusion criteria. Intervention Preoperative radiographs were categorized according to tibia and fibula fracture pattern, location and spatial relationship to each other. Preoperative CT scans were then evaluated to assess for the presence of an articular ankle injury. Main Outcome Measurements 1) incidence of concomitant tibial shaft fracture and ipsilateral ankle injury; and 2) statistical association between tibia and fibula fracture characteristics in patients with and without an ipsilateral ankle fracture. Results Thirty-five of 71 (49.3%) tibial shaft fracture patients had a concomitant ipsilateral ankle injury. Of these, 31 (88.6%) ankle injuries occurred in patients with a spiral pattern tibia fracture of the distal third diaphysis (p<0.001). A spiral pattern tibia fracture, a distal one-third tibial shaft fracture location or a spiral pattern fibula fracture all were significantly associated with the presence of an ipsilateral ankle injury (p=<0.001; p=0.001; and p=0.002). Patients with either a transverse pattern or absent fibula fracture, a non-spiral pattern tibia fracture or a midshaft diaphyseal tibia fracture location were significantly less likely to have an associated ankle injury (p=<0.001; p=<0.001; and p=0.012) Conclusions Ipsilateral ankle fractures are commonly associated with tibial shaft fractures, specifically distal one-third spiral type injuries. Recognition of an associated ankle injury is important as it can alter operative and postoperative management. Clinical studies are needed to examine patient outcomes with or without ipsilateral ankle injury to determine the clinical significance of this entity.

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“…Dedicated imaging studies are required in order to appropriately diagnose the injury. Recently, routine CT scans have been recommended for distal third tibial shaft fractures due to the high co-incidence of associated ankle fractures [10]. Similarly, we suggest considering CT scans of the knee when there is a suspicion for a proximal tibiofibular dislocation.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Dislocations of the Proximal Tibiofibular Associated with Tibial Fractures: Challenges in Diagnosis and Management

Zelle¹,

Webb²

2016

J Trauma Treat

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Approximately 1-2% of tibial fractures are associated with traumatic dislocations of the proximal tibiofibular joint. The associated injury pattern is frequently the result of a severe high-energy injury. Establishing the diagnosis of a proximal tibiofibular dislocation is frequently complicated by the fairly subtle clinical and radiographic presentation of this injury. Computer tomography scans of the knee should be considered for proper evaluation. Surgical treatment should consist of proper fixation of the tibial fracture followed by open reduction and internal fixation of the dislocated proximal tibiofibular joint. Multiple fixation options exist including screw, K-wire, and suture fixation constructs.

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Results of a Computed Tomography Protocol Evaluating Distal Third Tibial Shaft Fractures to Assess Noncontiguous Malleolar Fractures

Cited by 43 publications

References 17 publications

Concomitant Ankle Injuries Associated With Tibial Shaft Fractures

Concomitant Ankle Injuries Associated With Tibial Shaft Fractures

Predictive Radiographic Markers for Concomitant Ipsilateral Ankle Injuries in Tibial Shaft Fractures

Traumatic Dislocations of the Proximal Tibiofibular Associated with Tibial Fractures: Challenges in Diagnosis and Management

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