J Korean Foot Ankle Soc.  2015 Dec;19(4):156-160. 10.14193/jkfas.2015.19.4.156.

Usefulness of Computed Tomography in Patients with Acute Malleolar Fracture

• Jeon SH
• Bae SY
• Ahn SH
• Chung HJ
• Woo SH

• KMID: 2132457
• DOI: http://doi.org/10.14193/jkfas.2015.19.4.156

Abstract

PURPOSE
We compared plain radiographs with computed tomography (CT) images to evaluate the usefulness of preoperative CT in acute ankle malleolar fracture in terms of accuracy of diagnosis and planning of operative strategy.
MATERIALS AND METHODS
A retrospective analysis was conducted on 210 cases of malleolar fracture treated at our institute for which plain radiograph and CT were obtained preoperatively. Observers had reviewed plain radiographs and recorded fracture classification, anatomical diagnosis, extent and configuration of fractures and then subsequently reviewed CT images. Records from each image were compared and information regarding the differences in fractures was assessed.
RESULTS
Fractures were notably changed in appearance in 88 cases (41.9%) and diagnosis changed in 30 cases (14.3%). According to the change of diagnosis and fracture appearances, the operative strategy was changed in 15 cases (7.1%) including incision, order of reduction, and target of fixation.
CONCLUSION
CT could be a useful adjunctive imaging tool in addition to the plain radiograph in planning of operative treatment for acute malleolar fracture in terms of estimating exact configuration, extent of fractures and even newly revealed hidden fractures.

Keyword

Ankle; Malleolar fracture; Computed tomography

MeSH Terms

Ankle
Classification
Diagnosis
Humans
Retrospective Studies

Figure

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  Figure 1. (A) No definite posterior malleolus fracture was seen in plain radiograph. (B) Posterior malleolar fracture gap was revealed by computed tomography.

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  Figure 2. (A) Other fracture line was missed by initial plain radiograph. (B) Additional Chaput tubercle fracture was found after reviewing the axial view of computed tomography image. (C) Chaput tubercle fragment was fixed with one 2.7 mm cortical screw.

Reference

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