Is fibular fracture displacement consistent with tibiotalar displacement?

Michel P.J. Van Den Bekerom, C. Niek Van Dijk

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

We believed open reduction with internal fixation is required for supination-external rotation ankle fractures located at the level of the distal tibiofibular syndesmosis (Lauge-Hanssen SER II and Weber B) with 2 mm or more fibular fracture displacement. The rationale for surgery for these ankle fractures is based on the notion of elevated intraarticular contact pressures with lateral displacement. To diagnose these injuries, we presumed that in patients with a fibular fracture with at least 2 mm fracture displacement, the lateral malleolus and talus have moved at least 2 mm in a lateral direction without medial displacement of the proximal fibula. We reviewed 55 adult patients treated operatively for a supination-external rotation II ankle fracture (2 mm or more fibular fracture displacement) between 1990 and 1998. On standard radiographs, distance from the tibia to the proximal fibula, distance from the tibia to the distal fibula, and displacement at the level of the fibular fracture were measured. These distances were compared preoperatively and postoperatively. We concluded tibiotalar displacement cannot be reliably assessed at the level of the fracture. Based on this and other studies, we believe there is little evidence to perform open reduction and internal fixation of supination-external rotation II ankle fractures. Level of Evidence: Level IV, case series. See Guidelines for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)969-974
Number of pages6
JournalClinical Orthopaedics and Related Research
Volume468
Issue number4
DOIs
Publication statusPublished - Apr 2010
Externally publishedYes

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