Can CT-based assessment of lateral malleolus anatomy indicate when and how to perform an intramedullary fixation in distal fibula fractures? An analysis of 150 ankles.
Purpose: The primary aim was to analyse the lateral malleolus morphology with a focus on the shape of the distal fibula for IM fixation of the fibula in infra- and transsyndesmotic fracture patterns. The secondary aim was to propose a treatment algorithm according to the lateral malleolar anatomy. M...
| Publicado en: | European Journal of Orthopaedic Surgery & Traumatology Vol. 33; no. 3; pp. 601 - 610 |
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| Autores principales: | , , , , , , , , |
| Formato: | algorithm diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=162683459&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 162683459 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16338065 P4L jtl: European Journal of Orthopaedic Surgery & Traumatology issn: 16338065 maglogo: N pubinfo: dt: Apr2023 vid: 33 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 162683459 158592467 162683459 162683459 10.1007/s00590-022-03360-6 162683459 ppf: 601 ppct: 9 formats: tig: atl: Can CT-based assessment of lateral malleolus anatomy indicate when and how to perform an intramedullary fixation in distal fibula fractures? An analysis of 150 ankles. aug: au: Giordano, Vincenzo Azevedo, Pedro Henrique Peres, Caio Perucci, Marcelo Rodrigues, Matheus Meireles, Rafael Pires, Robinson Esteves Godoy-Santos, Alexandre Giannoudis, Peter V. affil: Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rua Mário Ribeiro 117/2º andar, Leblon, 22430-160, Rio de Janeiro, RJ, Brazil sug: subj: Ankle Fractures Diagnosis Ankle Fractures Radiography Ankle Fractures Surgery Fracture Fixation Methods Tomography, X-Ray Computed Ankle Anatomy and Histology Fibula Fractures Surgery Orthopedic Fixation Devices Human Male Female Young Adult Adult Middle Age Descriptive Statistics Data Analysis Software Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Purpose: The primary aim was to analyse the lateral malleolus morphology with a focus on the shape of the distal fibula for IM fixation of the fibula in infra- and transsyndesmotic fracture patterns. The secondary aim was to propose a treatment algorithm according to the lateral malleolar anatomy. Methods: 77 healthy, skeletally mature volunteers underwent CT scanning of the ankle. The fibula medullary canal and its cortical thickness were quantitatively analysed at 4 different levels measured from the fibular tip (1.5 cm, 3.0 cm, 4.5 cm, and 6.0 cm). A geometric classification was proposed, and a decision algorithm was developed. Statistical significance was set at a p-value < 0.05. Results: The smallest diameter of the medullary canal of the fibula was at 6.0 cm from the tip of the fibula, in 98.2% of the ankles. The distal fibula can be classified into triangular and rectangular type, according to the cortical thickness index (p < 0.0001). In 16.7% ankles, the internal diameter of the fibula at 6.0 cm was equal or narrower than 3.5 mm (p < 0.05). Conclusion: The shape of the distal fibula as evaluated by CT-guided analysis allows for IM osteosynthesis of the lateral malleolus in 83% of individuals. In our study, the smallest diameter of the medullary canal of the fibula was located 6.0 cm from the tip of the lateral malleolus. Coronal CT evaluation is advantageous in indicating which type of IM implant should be used safely for infra- and transsyndesmotic fracture patterns, potentially reducing intraoperative risks. pubtype: Academic Journal doctype: algorithm diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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