Names of used classification system were listed and their frequency in use was counted. Int Orthop 41(9):19351943. However, they described the classification using schematic drawings and also do not define the tibial incisura [32]. Am J Sports Med 33:14851491, Article The authors have no conflicts of interest. Eur J Trauma Emerg Surg 36(6):5159. You may walk on the foot as comfort allows although you may find it easier to walk with crutches in the early stages. Disagreements were discussed in a consensus meeting and if a disagreement persisted, a third reviewer (HW) made the final decision. The authors of the Mason classification see the advantage in the ascending degree of severity of the classification considering the accident mechanism. Foot Ankle Int 39(1):5966. An avulsion fracture occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone. Subsequently, the conviction increases that not the size, but the fracture morphology is crucial for the improvement of outcome [19]. Pak J Med Sci 36(3):438444. BMC Musculoskelet Disord 21(1):570. https://doi.org/10.1186/s12891-020-03594-7, Lee SW, Lee KJ, Park CH, Kwon HJ, Kim BS (2020) The valid diagnostic parameters in bilateral CT scan to predict unstable syndesmotic injury with ankle fracture. Clin Orthop Relat Res 330:157165, Article Clinical studies were included for data extraction. Lateral malleolus - end of the fibula The tibia and fibula form the ankle joint with structure and stability provided by the following connective tissues: Interosseous membrane Anterior, posterior, and transverse tibiofibular ligaments The collateral ligaments stabilize the joint against abduction and adduction forces. Stress placed on the bone by a tendon or ligament causes the fracture. Br J Sports Med 48:12351239, Kemler E, van de Port I, Backx F, van Dijk CN (2011) A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types. Arch Orthop Trauma Surg 134(3):38994. PubMed Pediatr Emerg Care 19:7378, Corrales LA, Morshed S, Bhandari M, Miclau T (2008) Variability in the assessment of fracture-healing in orthopaedic trauma studies. Google Scholar, Yde J (1980) The Lauge Hansen classification of malleolar fractures. Based on the number of patients included, the weighted median total Coleman score was 42.5. 56MWy52>(9a5.U,`u*wC7By*RCfoiEGH{"+r7TYL'J'W|Y*,qL"|!^'3S NSy+e |`> The plaster was used for the first 2 weeks. Foot Ankle Clin 22(1):125145. The following search algorithm was used: (posterior AND ankle AND fracture) OR (posterior AND (malleolus OR malleolar) AND fracture) OR (ankle AND volkmann) OR (trimalleolar AND fracture) OR (posterior AND pilon AND fracture). Arch Orthop Trauma Surg. https://doi.org/10.1016/j.fas.2019.01.003, Tosun B, Selek O, Gok U, Ceylan H (2018) Posterior malleolus fractures in trimalleolar ankle fractures: malleolus versus transyndesmal fixation. How fixation of a small posterior malleolar fragment neutralizes rotational forces in trimalleolar fractures. PubMed Central None of the reviewed PMF classifications has been able to establish itself decisively in the literature. endstream endobj startxref The boot you have been given is not needed to aid fracture healing but will help with your symptoms and should be worn whenever you're walking. https://doi.org/10.1053/j.jfas.2017.08.012, Miller MA, McDonald TC, Graves ML, Spitler CA, Russell GV, Jones LC, Replogle W, Wise JA, Hydrick J, Bergin PF (2018) Stability of the syndesmosis after posterior malleolar fracture fixation. Satoshi Yamaguchi. The lateral malleolus is part of the fibula, one of two bones of the lower leg, which carries about about 10% of your weight. J Ultrasound Med 36:421432, Najaf-Zadeh A, Nectoux E, Dubos F, Happiette L, Demondion X, Gnansounou M et al (2014) Prevalence and clinical significance of occult fractures in children with radiograph-negative acute ankle injury. All displaced or angulated fractures should have a reduction. Only Neumann et al. The same rehabilitation protocol was applied for both groups postoperatively. This study was supported by the Research Grant of the Japanese Orthopaedic Surgery for Sports Medicine. https://doi.org/10.1007/s00402-018-3056-0, Miller AN, Carroll EA, Parker RJ, Boraiah S, Helfet DL, Lorich DG (2009) Direct visualization for syndesmotic stabilization of ankle fractures. https://doi.org/10.1016/j.fas.2019.03.011, Karaca S, Enercan M, Ozdemir G, Kahraman S, Cobanoglu M, Kucukkaya M (2016) Importance of fixation of posterior malleolus fracture in trimalleolar fractures: a retrospective study. ment is considered the primary stabilizer of the ankle. One objection is the imprecise definition of type 5 fractures, which includes all fractures that cannot be classified as type 14. Surg Gynecol Obstet 71:509514, Mingo-Robinet J, Lopez-Duran L, Galeote JE, Martinez-Cervell C (2011) Ankle fractures with posterior malleolar fragment: management and results. In the included studies the most used cut-off value was 25%, but also values of 20%, 30% or 1/3 of the articular surface were used. Foot Ankle Int 42(4):389399. https://doi.org/10.1007/s00402-021-03772-9, Weigelt L, Hasler J, Flury A, Dimitriou D, Helmy N (2020) Clinical and radiological mid- to long-term results after direct fixation of posterior malleolar fractures through a posterolateral approach. Evaluation of the databases revealed 3.377 studies potentially relevant for inclusion. Studies reporting data on classification systems of trimalleolar ankle fractures were screened for using a PMF classification. J Bone Joint Surg Br 80:684688, Haraguchi N, Toga H, Shiba N, Kato F (2007) Avulsion fracture of the lateral ankle ligament complex in severe inversion injury: incidence and clinical outcome. 52, 20246, Hamburg, Germany, Julia Terstegen,Karl-Heinz Frosch,Tim Rolvien,Carsten Schlickewei&Elena Mueller, Department of Orthopedics, Bergman Clinics, Arnhem, The Netherlands, Department of Trauma Surgery, Orthopaedics, and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany, You can also search for this author in Eur J Trauma Emerg Surg 47(4):913920. Eur J Radiol 81(3):5947. https://doi.org/10.1177/1071100717735839, Huang Z, Liu Y, Xie W, Li X, Qin X, Hu J (2018) Pre-operative radiographic findings predicting concomitant posterior malleolar fractures in tibial shaft fractures: a comparative retrospective study. Modifications of the Haraguchi classification were found three times. Comparing the outcome of treating PMF less than 25% with that of not fixing it no significant difference in the AOFAS Score was found [55,56,57]. https://doi.org/10.1016/j.injury.2015.10.029, Ebraheim NA, Mekhail AO, Haman SP (1999) External rotation-lateral view of the ankle in the assessment of the posterior malleolus. Many classifications describing posterior malleolar fractures (PMF) exist. Most multi-fragmentary fractures cannot be defined using this classification [79]. https://doi.org/10.1177/1071100717745526, Levack AE, Warner SJ, Gausden EB, Helfet DL, Lorich DG (2018) Comparing functional outcomes after injury-specific fixation of posterior malleolar fractures and equivalent ligamentous injuries in rotational ankle fractures. Arch Orthop Trauma Surg 140(11):16411647. Most of the classifications are insufficient in terms of a derivable treatment algorithm or a prognosis with regard to outcome. Complex ankle fractures frequently involve the posterior malleolus. The sensitivity of the ATFL view for the diagnosis of avulsion fractures was 0.94, whereas that for the anteroposterior and lateral views was significantly lower at 0.46 (P<0.001). Avulsion fracture of the fibula associated with recurrent instability of the ankle. https://doi.org/10.1371/journal.pmed.1000097, Hinde S, Spackman E (2015) Bidirectional citation searching to completion: an exploration of literature searching methods. Injury 46(10):20249. Foot Ankle Int 31(11):95964. After noting that the Haraguchi classification did not map the mechanism of injury, Mason developed the most recent classification, also considering the injury mechanism [30]. https://doi.org/10.1016/j.injury.2022.02.046. The remaining studies used either 20% (4 studies), 30% (2 studies), or>1/3 of the joint area (5 studies) as the cut-off value, 1 study fixed the PMF in young patients or in the presence of subluxation from 10%, and 3 studies did not provide any information (Table 3). In the setting of an isolated lateral malleolus fracture, identifying injury to this ligament and associated ankle instability influences management. Stage 1 (The Acute Phase) The aim of this phase of treatment is the reduction of some symptoms of the fracture such as pain and swelling and preventing muscular atrophy in and around the affected region. Avulsion fracture of the distal fibula is associated with recurrent sprain after ankle sprain in children. https://doi.org/10.1097/00005373-200207000-00012, Broos PL, Bisschop AP (1991) Operative treatment of ankle fractures in adults: correlation between types of fracture and final results. +223 63 60 02 05. premier designs jewelry out of business. However, as the Bartonek/Rammelt classification has the greatest potential due to its treatment algorithm, its reliability in combination with consistent predictive values, its usage in clinical practice and research appears advisable. The kappa values of inter- and intraobserver reliability were interpreted as defined by Landis and Koch (<0.20: slight, 0.210.40: fair, 0.410.60: moderate, 0.610.80: substantial, 0.811.00: almost perfect) [36]. for PMF in tibial spiral fractures [54]. [60]. J Orthop Trauma 33(12):e459e465. a) Standing on an . https://doi.org/10.1016/j.fas.2021.02.009, Article There are two basic types of ankle fractures: 1) High Energy Axial Injuries: Pilon 2) Rotational Injuries: - Malleolar - either medial or lateral - Bimalleolar - both medial and lateral . Arch Pediatr 15:17491755, Lohman M, Kivisaari A, Kallio P, Puntila J, Vehmas T, Kivisaari L (2001) Acute paediatric ankle trauma: MRI versus plain radiography. Orthop Surg 12(6):16441651. https://doi.org/10.1053/j.jfas.2021.03.002, Fidan F, Polat A, Cetin MU, Kazdal C, Yavuz U, Lapcin O, Ozkaya U (2021) Fixation of posterior malleolar fractures with posterior plating through a posterolateral approach. Foot Ankle Int 36(6):6738. When a medial malleolus fracture occurs by. + Google Scholar, Cukiernik VA, Lim R, Warren D, Seabrook JA, Matsui D, Rieder MJ (2007) Naproxen versus acetaminophen for therapy of soft tissue injuries to the ankle in children. Informed consent was obtained from all patients and parents. 5.963 patients were female and 5.231 male, 11 studies did not report gender distribution [6, 20, 24, 37,38,39,40,41,42,43,44]. Hence, a paradigm shift has occurred [21, 24, 31, 77], as also the systematic review by Odak et al. 2022 Springer Nature Switzerland AG. Pharmacoeconomics 33(1):511. Minimally displaced or stable fractures: This type of fracture is barely out of place. https://doi.org/10.1016/j.arthro.2016.08.016, Naumann MG, Sigurdsen U, Utvag SE, Stavem K (2017) Associations of timing of surgery with postoperative length of stay, complications, and functional outcomes 36 years after operative fixation of closed ankle fractures. Int Orthop 42(1):191196. https://doi.org/10.1097/00007611-196510000-00022, Olerud C, Molander H (1986) Bi- and trimalleolar ankle fractures operated with nonrigid internal fixation. Google Scholar, Elsoe R, Ceccotti AA, Larsen P (2018) Population-based epidemiology and incidence of distal femur fractures. CAS In addition, a multi-fragmentary fracture of the entire tibial plafond may be mistaken for a two-part posterolateral and posteromedial fracture (type 2B) [32]. hbbd```b``"Z@$fHp0{dY&Y0lB:dhH%q03L I A type 2B fracture with a secondary posteromedial fragment, usually angled at 45 to the primary fragment, occurs when the talus continues to rotate in the mortise. Foot (Edinb) 43:101662. https://doi.org/10.1016/j.foot.2019.101662, Mller ME, Nazarian S, Koch P, Schatzker J (2012) The comprehensive classification of fractures of long bones. Recovery at a glance: No casting during recovery Come out of the boot and begin to move your ankle up and down immediately after surgery so your ankle does not get stiff. Treatment depends on the fracture location. 4% (103/2332) https://doi.org/10.1007/s40273-014-0205-3, Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD (2000) Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Part of Springer Nature. J Bone Joint Surg Am 95:e115(111116), Takaoka M, Suzuki K, Norbck D (2015) Sick building syndrome among junior high school students in Japan in relation to the home and school environment. et al. Patients with avulsion fracture and their parents should be informed about the risk of recurrent sprain and subsequent ankle instability, and careful follow-up is needed for these patients. The use of a posteromedial approach for type II fractures have resulted in good Olerud and Molander ankle score (OMAS)[64]. SLACK Incorporated Thorofare, NJ. https://doi.org/10.3113/FAI.2009.0419, Miller AN, Carroll EA, Parker RJ, Helfet DL, Lorich DG (2010) Posterior malleolar stabilization of syndesmotic injuries is equivalent to screw fixation. A total of 110 studies with a total of 12.614 patients were included. If the broken bone is stable and not dislocated, treatment may just. SY, YS, MK, TS, and SO performed the analysis and interpretation of data. J Foot Ankle Surg 61(1):109116. Rehabilitation Program Physical Therapy As always, acute management of ankle fractures involves analgesics for pain, immobilization, and patient comfort. J Orthop Trauma 23(3):20812. Posterior malleolar fracture (PMF), also known as malleolus tertius, posterior tibial fracture, or Volkmann-fragment appears in up to 44% of ankle fractures [3,4,5]. All classifications achieved a substantial to perfect score regarding the inter- and intraobserver reliability, with Mason scoring the lowest in comparison. Rotational forces applied to a loaded foot result in a type 2A fracture in form of a primary triangular posterolateral fragment. https://doi.org/10.1016/j.fcl.2016.09.009, Kleinertz H, Mueller E, Tessarzyk M, Frosch KH, Schlickewei C (2022) Computed tomography-based classifications of posterior malleolar fractures and their inter- and intraobserver reliability: a comparison of the Haraguchi, Bartonicek/Rammelt, and Mason classifications. Only studies written in English were considered, excluding further useful contributions written in other languages. Three studies reported on the reliability of the classification, all showing substantial interobserver reliability (Fleiss kappa 0.70/Cohens kappa 0.799/Cohens kappa 0.797) and substantial to almost perfect intraobserver reliability (Fleiss kappa 0.77/Cohens kappa 0.985) [24, 32, 59]. Impact on absenteeism and quality of life]. With the exception of one study describing a worse outcome in Mason type 3 fractures [68], there are no further statements on predictive values. Clin Orthop Relat Res 477(4):863869. As the bone breaks, the part of the bone that is attached to the tendon or ligament pulls away from the rest of the bone. Arch Orthop Trauma Surg 140(2):187195. Correspondence to There are still controversial opinions for osteosynthetic treatment of PMF [69]: McDaniel and Wilson demonstrated, that if a PMF of less than 25% of the tibial joint area was not reduced, it did not significantly affect the overall outcome [58]. found most intercalary fragments (more than 2/3) in type I fractures [28], and Kang et al. By reviewing the literature, 4 classifications were found describing PMF: a classification based on the fragment proportion in relation to the distal tibial joint surface [45] and the three CT-based classifications according to Haraguchi, Bartonek/Rammelt, and Mason [14, 29, 30]. https://doi.org/10.1016/s0020-1383(01)00199-1, de Muinck Keizer RO, Meijer DT, van der Gronde BA, Teunis T, Stufkens SA, Kerkhoffs GM, Goslings JC, Doornberg JN (2016) Articular gap and step-off revisited: 3D quantification of operative reduction for posterior malleolar fragments. Lateral malleolus fractures are common in running and jumping sports involving change of direction such as football, soccer, rugby, basketball and netball. wRguvk5^x|>3_iLVVVVK?1! Orthop Surg 9(1):6976. Alignment has been maintained. J Orthop Trauma 32(Suppl 1):S1S170. Until now, Mason's classification has been mentioned 22 times in literature, and used for classification in 12 studies, which were included and can be found in Table 6. Limitations affecting the Coleman score include the predominantly retrospective nature of the included studies and small patient cohorts. This confirmed the coronoid fracture and a humeral avulsion of the lateral ligament complex (Figs 6 and 7). XC!_4Z(P c,1>>!PV@!4o6^g$qJqH$1{JLCl7iX&VzlA+2a%4{35IM3e2|k8KQ!y|b6A'[ P,4 Ov'A/?!CG[S!VhpxKnYz'=74j/}81 xJ?7@88Iq o=))zA}>\ 1r|qN} n35%LHlfmGb#uI'l^;4OX$aXDk2|MNexsrH=@`wG7tPT`x`I0`: X5i?}so8>R}:=UIY Vnie=wIWcyVo^"}o>:a:Evl5+ uGVkrC|v:| X?*! https://doi.org/10.1097/CORR.0000000000000623, Testa G, Ganci M, Amico M, Papotto G, Giardina SMC, Sessa G, Pavone V (2019) Negative prognostic factors in surgical treatment for trimalleolar fractures. Compression stocking to be worn to control swelling along with ice/elevation 4 weeks non-weight bearing in boot, followed by 4 weeks of protected weight bearing in a boot https://doi.org/10.1007/s00264-017-3665-1, Court-Brown CM, McBirnie J, Wilson G (1998) Adult ankle fracturesan increasing problem? https://doi.org/10.1007/s00402-019-03259-8, Wang Y, Wang J, Luo CF (2016) Modified posteromedial approach for treatment of posterior pilon variant fracture. Google Scholar, Papachristou G, Efstathopoulos N, Levidiotis C, Chronopoulos E (2003) Early weight bearing after posterior malleolar fractures: an experimental and prospective clinical study. https://doi.org/10.1111/os.12318, Xing W, Wang Y, Sun L, Wang L, Kong Z, Zhang C, Zhang Z (2018) Ankle joint dislocation treating dislocated trimalleolar fractures accompanied with the complex posterior malleolus fracture without separation of the tibiofibular syndesmosis. The Bartonek/Rammelt classification has been found 46 times in the literature, of these, 21 studies have used it as a classification system, which were included in this study and are shown in Table 5. Therefore, Mason described type 1 as an extra-articular avulsion fracture following a rotational force applied to the foot when the ankle is in plantarflexion and the talus unloaded. Hence, the differentiation of pilon fractures from trimalleolar ankle fractures still often causes difficulties in clinical practice [75, 88, 89]. https://doi.org/10.1016/j.fas.2013.10.001, Kim MB, Lee YH, Kim JH, Lee JE, Baek GH (2015) Lateral transmalleolar approach and miniscrews fixation for displaced posterolateral fragments of posterior malleolus fractures in adults: a consecutive study. Injury 46(4):S109S113. Correspondence to %%EOF https://doi.org/10.5505/tjtes.2016.44844, Heim D, Niederhauser K, Simbrey N (2010) The Volkmann dogma: a retrospective, long-term, single-center study. Chin J Traumatol 16(5):2726, PubMed Foot Ankle Int 42(2):157165. Only specific PMF classifications were included; general ankle and/or pilon fracture classifications were excluded. This can take approximately 6 weeks to heal, although pain and swelling can be ongoing for 3 to 6 months. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery. Kumar et al. J Orthop Trauma 33(4):185188. J Bone Joint Surg Am 88(5):108592. 1 ). BMC Musculoskelet Disord 19(1):86. https://doi.org/10.1186/s12891-018-1982-1, Xing W, Xie P, Wang L, Liu C, Cui J, Zhang Z, Sun L (2018) The application of intraoperative ankle dislocation approach in the treatment of the unstable trimalleolar fractures involving posterior ankle comminuted fracture: a retrospective cohort study. https://doi.org/10.1016/s1067-2516(03)70009-x, Farsetti P, Caterini R, Potenza V, De Luna V, De Maio F, Ippolito E (2009) Immediate continuous passive motion after internal fixation of an ankle fracture. a Haraguchi type I b Haraguchi type II c Haraguchi type III. Google Scholar, Boutis K, Komar L, Jaramillo D, Babyn P, Alman B, Snyder B et al (2001) Sensitivity of a clinical examination to predict need for radiography in children with ankle injuries: a prospective study. The study selection and data extraction were independently performed by two review authors (JT, EM). Surgical Treatment Surgical repair is necessary when a lateral malleolus fracture is displaced. 7. 2). 0 k1: Usually, you will need to stay off the ankle for several weeks after surgery. J Orthop Trauma 32(4):e123e128. . https://doi.org/10.1007/s00402-015-2171-4, Mason LW, Marlow WJ, Widnall J, Molloy AP (2017) Pathoanatomy and Associated Injuries of Posterior Malleolus Fracture of the Ankle. Avulsion fractures are frequently missed on standard anteroposterior and lateral radiographs of the ankle [13, 18]. In multivariate logistic regression analysis, avulsion fracture was independently associated with recurrent sprain (P=0.027). Introduction:Traumatic rupture of posterior tibialis tendon in association with medial malleolus fracture is extremely rare.Case Presentation:We demonstrate our experience in the management of a co. volume27,pages 27742780 (2019)Cite this article. Keiler A, Riechelmann F, Thoni M, Brunner A, Ulmar B (2020) Three-dimensional computed tomography reconstruction improves the reliability of tibial pilon fracture classification and preoperative surgical planning. On Posted on Oktober 17, 2021 by to military onesource national guard lateral malleolus avulsion fracture rehabilitation protocol Injury 48(7):16621669. First, the classification is not based on severity and thus does not relate to functional outcome [78]. https://doi.org/10.1302/0301-620X.99B11.BJJ-2017-0558.R1, Mertens M, Wouters J, Kloos J, Nijs S, Hoekstra H (2020) Functional outcome and general health status after plate osteosynthesis of posterior malleolus fracturesthe quest for eligibility. Another CT-based classification was presented by Bartonek/Rammelt in 2015 [29]. Use either a well-padded posterior. SY, RA, SK, SA, and RN were responsible for the data acquisition. Ankle fractures present as one of the most common fractures with a prevalence of 49% [1, 2]. J Foot Ankle Surg 55(1):1405. Injury 52(10):31503155. Injury 47(10):23602365. Nowadays, it is generally believed that the morphology of the fragment is more closely related to the fracture pattern and is, therefore, more important in classifying the fracture [14, 19,20,21]. Ann Pharmacother 41:13681374, Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C (2014) The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. https://doi.org/10.2214/ajr.154.5.2108536, Yao L, Zhang W, Yang G, Zhu Y, Zhai Q, Luo C (2014) Morphologic characteristics of the posterior malleolus fragment: a 3-D computer tomography based study. https://doi.org/10.1007/s00068-010-0061-6, Schoenmakers S, Houben M, van Hoeve S, Willems P, Meijer K, Poeze M (2022) The influence of size and comminution of the posterior malleolus fragment on gait in trimalleolar ankle fractures. The purpose of this study was to clarify radiographic and clinical outcomes, as well as their association, of ankle sprain in children. https://doi.org/10.1007/s00402-018-3099-2, Hendrickx LAM, Cain ME, Sierevelt IN, Jadav B, Kerkhoffs G, Jaarsma RL, Doornberg JN (2019) Incidence, predictors, and fracture mapping of (occult) posterior malleolar fractures associated with tibial shaft fractures. reported a better outcome with surgical treatment of type I fractures smaller than 25% [49]. An avulsion fracture is where a fragment of bone is pulled away at the ligamentous or tendinous attachment. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. PubMed alibaba china gift card; composition of linear maps; despite of this pandemic; birkenstock buckley shearling . https://doi.org/10.1097/BOT.0000000000000676, Sobol GL, Shaath MK, Reilly MC, Adams MR, Sirkin MS (2018) The incidence of posterior malleolar involvement in distal spiral tibia fractures: is it higher than we think? EFORT Open Rev 3(1):2429. J Orthop Trauma 8(4):32831. In addition, there are studies showing that posterior pilon fractures are a separate entity due to morphological differences [61, 94]. Foot Ankle Surg 26(3):289294. Sports Med 41:185197, Kwak YH, Lim JY, Oh MK, Kim WJ, Park KB (2015) Radiographic diagnosis of occult distal fibular avulsion fracture in children with acute lateral ankle sprain. J Infect Public Health 13(12):20492054. Injury 48(Suppl 5):S65S69. observed an improvement in the AOFAS score from type I to type III [65]. Acta Orthop Scand 69(1):437. This study did not involve human participants. _(2PHEPc55b)Y3V,)>'R"Tf#[8g.sRB,*0P[J3n(0epE:Dt!N08JaP$s,CY&+wl r]Mv!k1>cr40l8b/g3&~7K&WltY*~?/GuYWMIMSjZf'igmu;['gi6t?qjs5QU-8Y+y^5>?_~],BkXnB/Z/vyW.6ey{ss*yt3j-5YIja]g7gyx6XaU\jv_/W~mZdK{x4.>,Idw`O{L}z_-$wc5O@ $pI36O[!&6k'ca&N3g(tA$Os3aA,4zl(XBt+LKuqqfN^EE`.fPj-V*RTD@,+[E4; -_Zm^ W=9_dvTH_Nu7tl|,W*_J_EHM+mZ\\\!q;%%d`@,aI.o~y}A:#((/4M5KE-xghZ!r!R Data were extracted from the included studies using a Microsoft Office Excel spreadsheet. https://doi.org/10.1097/BOT.0000000000000330, Neumann AP, Rammelt S (2021) Ankle fractures involving the posterior malleolus: patient characteristics and 7-year results in 100 cases. Acta Chir Orthop Traumatol Cech 88(3):204210 (Zalezi na metode fixace zadniho maleolarniho fragmentu u trimaleolarni zlomeniny? PubMed J Orthop Trauma 33(12):e452e458. Coleman score points are shown in Table 1. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in There were no limitations on journal or publication date of the article. https://doi.org/10.1016/j.fas.2018.04.008, Regier M, Petersen JP, Hamurcu A, Vettorazzi E, Behzadi C, Hoffmann M, Grossterlinden LG, Fensky F, Klatte TO, Weiser L, Rueger JM, Spiro AS (2016) High incidence of osteochondral lesions after open reduction and internal fixation of displaced ankle fractures: Medium-term follow-up of 100 cases. Data analysis was performed using IBM SPSS Statistics Version 26.0 (IBM Corp., Armonk, NY, USA). Skeletal Radiol 30:504511, Maeda M, Maeda N, Takaoka T, Tanaka Y (2017) Sonographic findings of chondral avulsion fractures of the lateral ankle ligaments in children. https://doi.org/10.1016/j.jiph.2019.06.022, Amorosa LF, Brown GD, Greisberg J (2010) A surgical approach to posterior pilon fractures. https://doi.org/10.1053/j.jfas.2005.02.002, Xu HL, Li X, Zhang DY, Fu ZG, Wang TB, Zhang PX, Jiang BG, Shen HL, Wang G, Wang GL, Wu XB (2012) A retrospective study of posterior malleolus fractures. https://doi.org/10.1016/j.injury.2017.03.039, Vidovic D, Elabjer E, Muskardin IVA, Milosevic M, Bekic M, Bakota B (2017) Posterior fragment in ankle fractures: anteroposterior vs posteroanterior fixation. With 66 included studies, this classification accounts for the largest proportion of classifications used by surgeons in clinical practice. PubMed Wir verwenden Cookies, um unsere Website und unseren Service zu optimieren. Injury. 185 0 obj <> endobj [@Y;sl>7{O - Lateral shuffles Consequently, with regard to the proportion of the affected joint surface and recommendation for surgical fixation of PMF, there is a shift away from the 1/3 dogma [7, 17, 22,23,24,25,26,27,28]. Glob J Health Sci 8:165177, Vahvanen V, Westerlund M, Kajanti M (1983) Sprained ankle in children. https://doi.org/10.1007/s00068-015-0560-6, Zhang Y, Qin X, Song L, Li X (2018) The risk of violating the posterior malleolar fracture when nailing the ipsilateral concomitant spiral distal tibial fracture. Bone Joint J 99-B(11):14961501. a Mason type 1 b Mason type 2A c Mason type 2B d Mason type 3. J Orthop Sci 15:524530, Pill SG, Hatch M, Linton JM, Davidson RS (2013) Chronic symptomatic os subfibulare in children. PubMed Nine studies reported a better outcome with reduction of smaller posterior malleolus fragments [4, 6, 7, 46,47,48,49,50,51], whereas seven studies reported no difference between fixation and no fixation of smaller posterior malleolus fragments [52,53,54,55,56,57,58]. Therefore, the results of this study could only be presented in a descriptive manner. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Ununited osteochondral fractures of the distal fibula. Yamaguchi, S., Akagi, R., Kimura, S. et al. https://doi.org/10.1097/TA.0b013e3181e4f81e, Langenhuijsen JF, Heetveld MJ, Ultee JM, Steller EP, Butzelaar RM (2002) Results of ankle fractures with involvement of the posterior tibial margin. Eur J Trauma Emerg Surg. The methodological quality of the included studies was quantified using the modified Coleman score. PubMed Central Treatment usually requires surgery, and the recovery process can take months. Arch Orthop Trauma Surg (2022). Of 114 (follow-up rate, 80%) patients who were followed up for a median period of 24 months, recurrent sprain occurred in 41 (36%) patients. Diagnostics (Basel). Soft tissue swelling over the lateral malleolus. 380 studies were eligible for full-text analysis, after applying the exclusion criteria (no clinical study, case reports<10 patients, no classification/no PMF-specific classification), 110 remaining relevant studies were included in this review. Hansen ST (2000) Functional reconstruction of the foot and ankle. Biomed Res 28(14):64986503, Pilskog K, Gote TB, Odland HEJ, Fjeldsgaard KA, Dale H, Inderhaug E, Fevang JM (2021) Traditional approach vs posterior approach for ankle fractures involving the posterior malleolus. endstream endobj 186 0 obj <>/Metadata 7 0 R/PageLayout/OneColumn/Pages 183 0 R/StructTreeRoot 11 0 R/Type/Catalog>> endobj 187 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 188 0 obj <>stream Pediatrics 119:e1256e1263, Busconi BD, Pappas AM (1996) Chronic, painful ankle instability in skeletally immature athletes. The other two are the lateral and the posterior malleolus. J Bone Joint Surg Am 92:22792284. Archives of Orthopaedic and Trauma Surgery Mertens et al. BMC Musculoskelet Disord 19(1):51. https://doi.org/10.1186/s12891-018-1974-1, Hou Z, Zhang Q, Zhang Y, Li S, Pan J, Wu H (2009) A occult and regular combination injury: the posterior malleolar fracture associated with spiral tibial shaft fracture. https://doi.org/10.1016/S0020-1383(17)30743-X, Shi HF, Xiong J, Chen YX, Wang JF, Qiu XS, Huang J, Gui XY, Wen SY, Wang YH (2017) Comparison of the direct and indirect reduction techniques during the surgical management of posterior malleolar fractures. With increasing understanding of fracture morphology and the routine use of computed tomography (CT), efforts have been made in recent years to establish new classification systems based on CT imaging [14, 29, 30]. Google Scholar, van den Bekerom MP, Kerkhoffs GM, McCollum GA, Calder JD, van Dijk CN (2013) Management of acute lateral ankle ligament injury in the athlete. Talus fractures can be classified by how much the pieces of bone have moved out of their normal position. They have also introduced treatment recommendations based on their classification. The earliest and most commonly used classification was the PMF Classification according to fracture size as first specified by Nelson and Jensen, who postulate a recommendation for treatment of PMF with a fragment size exceeding more than 1/3 of the articular surface on lateral radiographs based on a study sample consisting of 8 patients [45]. 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