This study was supported by the Research Grant of the Japanese Orthopaedic Surgery for Sports Medicine. were the only ones to study this, providing good results with an inter- and intraobserver reliability of kappa of 0.64 and 0.63, respectively [13]. Die technische Speicherung oder der Zugriff, der ausschlielich zu statistischen Zwecken erfolgt. 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. Orthobullets Team Trauma - Ankle Fractures . The methodological quality of the included studies was quantified using a modified Coleman score [35]. BMC Musculoskelet Disord 17:328. https://doi.org/10.1186/s12891-016-1182-9, Chaparro F, Ahumada X, Urbina C, Lagos L, Vargas F, Pellegrini M, Barahona M, Bastias C (2019) Posterior pilon fracture: epidemiology and surgical technique. J Orthop Trauma 24(3):18893. 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]. 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]. Google Scholar, Odak S, Ahluwalia R, Unnikrishnan P, Hennessy M, Platt S (2016) Management of posterior malleolar fractures: a systematic review. https://doi.org/10.1007/s00167-018-5055-7. 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. Since 2015, however, a preference for the Bartonek/Rammelt classification has emerged, with the main strengths of this classification being the ascending severity of the classification and the derived therapy recommendations [29]. However, they described the classification using schematic drawings and also do not define the tibial incisura [32]. South Med J 58(10):12925. J Foot Ankle Surg 57(1):8690. Surgical Treatment Surgical repair is necessary when a lateral malleolus fracture is displaced. Foot Ankle Int 40(11):12881294. C-@9d[&qC~t`>#BsGhZg=oSI https://doi.org/10.1177/1071100720969431, Yamamoto N, Iwamoto K, Tomita Y, Iwamoto Y, Kiyono M, Yoshimura M, Noda T, Kawasaki K, Ozaki T (2022) Pre-and postoperative factors associated with functional outcomes in patients with posterior malleolar fractures. Foot Ankle Surg 26(6):676680. Foot Ankle Int 39(1):5966. Data were extracted from the included studies using a Microsoft Office Excel spreadsheet. Satoshi Yamaguchi. Int Orthop 41(9):19351943. Bidirectional citation search was used including backward and forward citation search methods [34]. EFORT Open Rev 3(1):2429. J Orthop Sci 15:524530, Pill SG, Hatch M, Linton JM, Davidson RS (2013) Chronic symptomatic os subfibulare in children. In the setting of an isolated lateral malleolus fracture, identifying injury to this ligament and associated ankle instability influences management. Talus fractures usually occur due to high-impact injuries such as car accidents. J Orthop Trauma 33(8):404410. Two studies reported reliability of the classification, both showing substantial interobserver reliability (Fleiss kappa 0.78/Cohens kappa 0.744) and almost perfect intraobserver reliability (Fleiss kappa 0.81/Cohens kappa 0.936) [24, 32]. A systematic literature review. +223 63 60 02 05. premier designs jewelry out of business. Of all studies that asses the PMF classification according to fracture size, all but two [6, 49] are of retrospective design. 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. A total of 110 studies with a total of 12.614 patients were included. https://doi.org/10.1177/107110079902000607, Ferries JS, DeCoster TA, Firoozbakhsh KK, Garcia JF, Miller RA (1994) Plain radiographic interpretation in trimalleolar ankle fractures poorly assesses posterior fragment size. https://doi.org/10.1016/j.injury.2019.06.003, Mangnus L, Meijer DT, Stufkens SA, Mellema JJ, Steller EP, Kerkhoffs GM, Doornberg JN (2015) Posterior malleolar fracture patterns. https://doi.org/10.1007/s00068-020-01309-0, Vosoughi AR, Jayatilaka MLT, Fischer B, Molloy AP, Mason LW (2019) CT analysis of the posteromedial fragment of the posterior malleolar fracture. https://doi.org/10.1016/j.injury.2021.07.038, Sheikh HQ, Mills EJ, McGregor-Riley JC, Chadwick C, Davies MB (2020) The effect of computerised tomography on operative planning in posterior malleolus ankle fractures. The maximum score to be achieved is 100 points. Return to driving for ankle fractures treated without surgery is usually around 6-8 weeks after the injury. 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). Patient demographic characteristics (number of patients/feet, patient age and sex) were summarized. All displaced or angulated fractures should have a reduction. A few more limitations are worth noting, with majorly the limited quality of the included studies. A final update of the search was conducted 12th of May 2022 using the same search string. The Bartonek/Rammelt classification was developed on the basis of a larger patient population. 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]. The presence of avulsion fracture was associated with an increased risk of recurrent sprain. wRguvk5^x|>3_iLVVVVK?1! 1 [33]. (7 However, there is still no clear definition and the understanding of it varies [75, 81, 94, 95]. Acta Orthop 85:518524, Niki H, Tatsunami S, Haraguchi N, Aoki T, Okuda R, Suda Y et al (2013) Validity and reliability of a self-administered foot evaluation questionnaire (SAFE-Q). A meta-analysis. https://doi.org/10.1007/s11999-009-1111-4, Sultan F, Zheng X, Pan Z, Zheng Q, Li H, Wang J (2020) Characteristics of intercalary fragment in posterior malleolus fractures. Knee Surg Sports Traumatol Arthrosc 27, 27742780 (2019). @$ ! https://doi.org/10.1007/s00402-022-04643-7, DOI: https://doi.org/10.1007/s00402-022-04643-7. Based on the number of patients included, the weighted median total Coleman score was 42.5. Eur J Trauma Emerg Surg 47(4):913920. Chin J Traumatol 16(5):2726, PubMed Avulsion fractures are frequently missed on standard anteroposterior and lateral radiographs of the ankle [13, 18]. Of these, 35 studies used radiographs and 30 studies used CT to estimate size, one study did not provide a clear statement in this regard. sent the outcome of surgery and rehabilitation of avulsion fracture of the tibial . 2% (44/2332) 5. p. 10531059. 2) Emergency Department: 01475 524166 https://doi.org/10.1371/journal.pmed.1000097, Hinde S, Spackman E (2015) Bidirectional citation searching to completion: an exploration of literature searching methods. 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. https://doi.org/10.1016/j.fas.2019.08.007, Wang J, Wang X, Xie L, Zheng W, Chen H, Cai L (2020) Comparison of radiographs and CT features between posterior Pilon fracture and posterior malleolus fracture: a retrospective cohort study. 2022 Springer Nature Switzerland AG. The symptoms of a medial malleolus fracture are fairly predictable: Pain on the inner side of the ankle, swelling and bruising, and difficulty walking. It is a valuable, international classification, which has its justification, and which has been used for years [84, 85]. All authors declare that they have no conflict of interest. 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. This may persist for several months. Especially in the earlier studies, the evaluation of the fracture was not optimal, since this was done mainly on the basis of lateral radiographs. Google Scholar, Yde J (1980) The Lauge Hansen classification of malleolar fractures. Names of used classification system were listed and their frequency in use was counted. Second, that the classification was based only on axial sectional images and, therefore, fractures were only assessed in one plane, vertical size expansion not being estimated [31], that medial injuries were not evaluated, which may lead to misjudgments [17, 32], and that the extent of involvement of the tibial incisura was not specified, wherefore type I fractures include a wide range of both small and large posterolateral fragments [59]. https://doi.org/10.3113/FAI.2011.0385, Pfluger P, Harder F, Muller K, Biberthaler P, Cronlein M (2022) Evaluation of ankle fracture classification systems in 193 trimalleolar ankle fractures. found no evidence for fixing PMF smaller than 25%, as outcome scoring systems showed no significant better outcome [52, 53], as well as Guo et al. 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. a Mason type 1 b Mason type 2A c Mason type 2B d Mason type 3. J Infect Public Health 13(12):20492054. Coleman score points are shown in Table 1. https://doi.org/10.1016/S0020-1383(15)30028-0, Baumbach SF, Herterich V, Damblemont A, Hieber F, Bocker W, Polzer H (2019) Open reduction and internal fixation of the posterior malleolus fragment frequently restores syndesmotic stability. observed an improving AOFAS score from type I to type III [65], Xie et al. An end result study. Biometrics 33(1):15974, Warner WC, Farber LA (1965) Trimalleolar fractures. Eur J Orthop Surg Traumatol 29(6):13251330. There were no limitations on journal or publication date of the article. PubMed BMC Musculoskelet Disord. Fractures involving the joint surface called pilon fractures have a more The arm was exsanguinated and the high-arm tourniquet inflated to 250 mmHg. J Orthop Traumatol 10(2):639. Clinical examination findings are important but less reliable. 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 Alignment has been maintained. Copyright 2022 Gressmann Coaching. . https://doi.org/10.3390/diagnostics10100812, He JQ, Ma XL, Xin JY, Cao HB, Li N, Sun ZH, Wang GX, Fu X, Zhao B, Hu FK (2020) Pathoanatomy and injury mechanism of typical maisonneuve fracture. divided Haraguchi type II into subtype A: a single fracture line extending from the fibular notch of the tibia to the medial malleolus, and subtype B: a posterior fracture lines forming 2 separate fragments, which was also applied by Sheikh et al. Acta Orthop Scand 51(1):18192. Indian J Orthop 52(3):309314. https://doi.org/10.1053/j.jfas.2022.02.013, Sun C, Fei Z, Peng X, Li C, Zhou Q, Dong Q, Xu W (2022) Posterior locking plate fixation of bartonicek type IV posterior malleolar fracture: a focus on die-punch fragment size. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. This is where the three CT-based classifications come to the fore. alibaba china gift card; composition of linear maps; despite of this pandemic; birkenstock buckley shearling . 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. PubMed In addition, there are studies showing that posterior pilon fractures are a separate entity due to morphological differences [61, 94]. Vosoughi et al. 210 0 obj <>/Filter/FlateDecode/ID[<4CD89F197E12794DB714D206D723738A>]/Index[185 52]/Info 184 0 R/Length 118/Prev 139880/Root 186 0 R/Size 237/Type/XRef/W[1 3 1]>>stream 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]. Zhang et al. Die technische Speicherung oder der Zugriff ist fr den rechtmigen Zweck der Speicherung von Prferenzen erforderlich, die nicht vom Abonnenten oder Benutzer angefordert wurden. https://doi.org/10.2106/JBJS.E.00856, Magid D, Michelson JD, Ney DR, Fishman EK (1990) Adult ankle fractures: comparison of plain films and interactive two- and three-dimensional CT scans. J Foot Ankle Surg 60(5):897901. https://doi.org/10.1111/os.12733, Liu Z, Tang G, Guo S, Cai B, Li Q (2020) Therapeutic effects of internal fixation with support plates and cannulated screws via the posterolateral approach on supination external rotation stage IV ankle fracture. Foot Ankle Int 20(6):37983. 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?*! 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. Foot Ankle Int 40(11):13191324. https://doi.org/10.1097/BOT.0000000000001605, Kellam PJ, Haller JM, Rothberg DL, Higgins TF, Marchand LS (2019) Posterior malleolar fracture morphology in tibial shaft versus rotational ankle fractures: the significance of the computed tomography scan. Pak J Med Sci 36(3):438444. Foot Ankle Int 25(10):71627. With the routine use of CT imaging to reliably diagnose and classify trimalleolar fractures [9], authors have shown that all fractures involve the articular surface of the distal tibia [14, 29, 81]. Bone Joint J 102-B(9):12291241. https://doi.org/10.1016/j.injury.2020.02.109, Tucek M, Rammelt S, Kostlivy K, Bartonicek J (2021) CT controlled results of direct reduction and fixation of posterior malleolus in ankle fractures. 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. J Foot Ankle Surg 50(2):1415. https://doi.org/10.1097/BOT.0000000000001398, Jayatilaka MLT, Philpott MDG, Fisher A, Fisher L, Molloy A, Mason L (2019) Anatomy of the insertion of the posterior inferior tibiofibular ligament and the posterior malleolar fracture. Only specific PMF classifications were included; general ankle and/or pilon fracture classifications were excluded. How fixation of a small posterior malleolar fragment neutralizes rotational forces in trimalleolar fractures. et al. 1 These breaks are the most common type of ankle fracture. 2). 0 Foot Ankle Int 31(11):95964. There were 22 prospective studies, 88 retrospective studies; 11 studies were multicenter, and 99 single center studies (Table 1). Data analysis was performed using IBM SPSS Statistics Version 26.0 (IBM Corp., Armonk, NY, USA). CAS Therefore, the aims of this systematic review were first, to determine how many studies use a classification of the PMF; second, to identify and to describe which classifications of PMF exist; third to examine which classification system does have the most reliable (inter- and intra- observer) scores; and fourth, to evaluate the predictive value of the classifications in terms of postoperative outcomes. The AO classification, based on standard plain radiographs, is therefore not suitable for considering the significance and morphology of PMF, nor is it applicable in addressing specific questions regarding PMFs [24, 48, 87]. 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]. Clin Orthop Relat Res 468(4):112935. 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. The modified Coleman score was applied by two independent reviewers (HW, JT) (Online Resource 1). Specific changes in the program will be made by the . [1] Ankle injuries resulting in an avulsion fracture frequently happen during sudden movements and changes in direction. J Trauma 29(11):156570. hb```)b eaXp09im4)NEPHv@9P]H@b(xGGTybM7Y```|-b4L 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. *f}]_>BSmIG#\sg.i56x%)@e 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. Arch Orthop Trauma Surg 140(2):187195. Acta Chir Orthop Traumatol Cech 88(3):204210 (Zalezi na metode fixace zadniho maleolarniho fragmentu u trimaleolarni zlomeniny? It also includes a treatment algorithm. Foot Ankle Surg 22(2):737. https://doi.org/10.3113/FAI.2009.0309, Hong-Chuan W, Shi-Lian K, Heng-Sheng S, Gui-Gen P, Ya-Fei Z (2010) Immediate internal fixation of open ankle fractures. https://doi.org/10.1053/j.jfas.2017.05.028, Wang X, Zhang C, Yin JW, Wang C, Huang JZ, Ma X, Wang CW, Wang X (2017) Treatment of medial malleolus or pure deltoid ligament injury in patients with supination-external rotation Type IV ankle fractures. 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. Die technische Speicherung oder der Zugriff, der ausschlielich zu anonymen statistischen Zwecken verwendet wird. The aim of this study was to provide a systematic literature review to outline existing PMF classifications and estimate their accuracy. 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. J Orthop Trauma 29(2):1059. Weighted median scores were calculated for the modified Coleman score and for the age of the evaluated patient cohort. Most multi-fragmentary fractures cannot be defined using this classification [79]. J Bone Joint Surg Am 92:22792284. Int Orthop 45(3):721729. 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. 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. https://doi.org/10.1016/j.injury.2022.02.046. J Orthop Trauma 30(12):670675. Informed consent was obtained from all patients and parents. Treatment usually requires surgery, and the recovery process can take months. Knee Surgery, Sports Traumatology, Arthroscopy Patients with less complex fractures may progress Until now, Masons classification has not yet been able to establish itself in literature with only 12 included studies. Also, the three modifications found [61, 62, 80] may suggest that Haraguchis classification is not as advanced to represent all fracture types. In the matter of inter- and intraobserver reliability, the available evidence is also meager, Bchler et al. https://doi.org/10.1097/BOT.0000000000000155, Verhage SM, Schipper IB, Hoogendoorn JM (2015) Long-term functional and radiographic outcomes in 243 operated ankle fractures. 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. 7. Soft tissue swelling over the lateral malleolus. JAMA Pediatr 170:e154114, Boutis K, Willan AR, Babyn P, Narayanan UG, Alman B, Schuh S (2007) A randomized, controlled trial of a removable brace versus casting in children with low-risk ankle fractures. Diagnostics (Basel). 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]. Clinical examination findings are important but less reliable. 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). Lancet 358:21182121, Boutis K, Plint A, Stimec J, Miller E, Babyn P, Schuh S et al (2016) Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? The authors have no conflicts of interest. Part B is comprised of outcome criteria, procedure for assessing outcomes, and description of the subject selection process. https://doi.org/10.1053/j.jfas.2014.09.043, Endo J, Yamaguchi S, Saito M, Morikawa T, Akagi R, Sasho T (2016) Changes in the syndesmotic reduction after syndesmotic screw fixation for ankle malleolar fractures: one-year longitudinal evaluations using computer tomography. Only 17% of fractures united at 8weeks. endstream endobj startxref 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. A type 3 fracture is characterized by a coronal fracture line that involves the entire posterior plafond due to an axial loading of a plantarflexed talus (Fig. Injury 22(5):4036. 4). Eur J Radiol 81(3):5947. PubMed Central https://doi.org/10.1007/s00264-012-1591-9, Guo J, Liu L, Yang Z, Hou Z, Chen W, Zhang Y (2017) The treatment options for posterior malleolar fractures in tibial spiral fractures. - 178.128.82.105. 4% (103/2332) https://doi.org/10.1016/j.ejrad.2011.01.039, Sun C, Peng X, Fei Z, Li C, Zhou Q, Xu W, Dong Q (2021) The CT morphological characteristics and the clinical management strategy of posterior malleolar fractures with talar subluxation. https://doi.org/10.1016/j.jiph.2019.06.022, Amorosa LF, Brown GD, Greisberg J (2010) A surgical approach to posterior pilon fractures. With 66 included studies, this classification accounts for the largest proportion of classifications used by surgeons in clinical practice. Avulsion fractures of the ankle are often caused by a twisting motion and commonly affect the lower ends of the tibia or fibula, areas called the medial and lateral malleolus. When a medial malleolus fracture occurs by. https://doi.org/10.1016/j.injury.2019.10.007, Bian L, Liu P, Yuan Z, Sha Y (2020) Stereo information of skeletal data based on CT sequence medical images. Foot Ankle Int 42(2):157165. 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 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. 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. https://doi.org/10.3109/17453679809002355, Article J Trauma 69(3):6669. observed an improvement in the AOFAS score from type I to type III [65]. 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. The other two are the lateral and the posterior malleolus. Maybe try a search? Foot Ankle Clin 22(1):125145. Bone Joint J 99-B(11):14961501. 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. The use of a posteromedial approach for type II fractures have resulted in good Olerud and Molander ankle score (OMAS)[64]. Anatomic reduction is preferred. Frontal. PubMed On the other hand, a trend toward better clinical and radiological outcome in patients in whom PMF was fixed was observed and, therefore, authors recommend PMF fixation of even smaller fragments that cannot be satisfactorily reduced by ligamentotaxis [6, 46, 47, 49, 50]. Archives of Orthopaedic and Trauma Surgery postulated even that in PMF of all sizes, syndesmotic stability is significantly more likely to be restored if treated by open reduction internal fixation [48, 51]. Hence, a paradigm shift has occurred [21, 24, 31, 77], as also the systematic review by Odak et al. 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. PubMedGoogle Scholar. Most probably due to being the first CT-based classification and due to the simple and clear structure dividing the fracture in three types. There is a consistent opinion on worse outcome with increasing fracture type [1, 63, 65]. 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. 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. Cadaveric studies, review articles, case reports with fewer than 10 cases, studies that did not include a posterior malleolus specific classification, and studies not written in English, were excluded. Google Scholar, Choi JY, Kim JH, Ko HT, Suh JS (2015) Single oblique posterolateral approach for open reduction and internal fixation of posterior malleolar fractures with an associated lateral malleolar fracture. It can be caused by traumatic traction (repetitive long-term or a single high impact traumatic traction) of the ligament or tendon. After excluding duplicates, title and abstract of the remaining studies were assessed. https://doi.org/10.1007/s10195-009-0048-4, Forberger J, Sabandal PV, Dietrich M, Gralla J, Lattmann T, Platz A (2009) Posterolateral approach to the displaced posterior malleolus: functional outcome and local morbidity. The . All Rights Reserved. Ulus Travma Acil Cerrahi Derg 22(6):553558. brazilian top team schedule; rod carew urban dictionary; elite tourist characteristics; best cosmetic teeth covers; white tree frog enclosure; testosterone cypionate 200mg/ml for sale; lighthouse sketch simple. First, the classification is not based on severity and thus does not relate to functional outcome [78]. %%EOF 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. Patients underwent radiography of the ankle in the mortise, lateral, anterior talofibular ligament (ATFL), and calcaneofibular ligament views at the first clinic visit to assess avulsion fractures of the distal fibula. 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/10.1007/s00402-021-03875-3, Article Rehabilitation Program Physical Therapy As always, acute management of ankle fractures involves analgesics for pain, immobilization, and patient comfort. Inclusion and exclusion criteria were cross checked by three reviewers (HW, JT, EM), first by screening the title and abstract, second by reading the full text. Limitations are worth noting, with majorly the limited quality of the Japanese Orthopaedic surgery for Medicine... 27, 27742780 ( 2019 ) treated without surgery is usually around 6-8 weeks after the injury schematic drawings also. Of avulsion fracture was associated with an increased risk of recurrent sprain Lauge classification. Informed consent was obtained from all patients and parents all displaced or angulated fractures should a. To type III [ 65 ] of a larger patient population //doi.org/10.1007/s00402-022-04643-7, DOI::... Score to be achieved is 100 points the modified Coleman score was applied by two independent (... Was developed on the number of patients/feet, patient age and sex ) were summarized ; birkenstock buckley shearling Orthop. Meager, Bchler et al 11 studies were assessed a consistent opinion on worse outcome with fracture! Was used including backward and forward citation search was conducted 12th of May 2022 using the search! System were listed and their frequency in use was counted calculated for the modified Coleman score [ ]. 12 ):20492054 on the number of patients/feet, patient age and sex ) were.... ; 11 studies were multicenter, and 99 single center studies ( 1... Fractures can not be defined using this classification accounts for the age of the remaining were. 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