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KMID : 0950120110100020078
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Jouranl of Korean Orthopaedic Sports Medicine
2011 Volume.10 No. 2 p.78 ~ p.85
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The usefulness of CT for the diagnosis and the fragment fixation of anteroinferior tibiofibular ligament avulsion fracture in ankle fracture
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Na Hwa-Yeop
Cho Kook-Hee
Jung Yu-Hun
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Abstract
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Purpose: To evaluate the usefulness of computerized tomography (CT) for the diagnosis and the fragment fixation of anteroinferior tibiofibular ligament avulsion fracture in ankle fracture.
Materials and Methods: We retrospectively studied 108 patients with an ankle fracture who had been checked with plain radiographs and CT from July 2006 to July 2010. They were divided into two groups; patients with (19 patients) and without (89 patients) an avulsion fracture of anteroinferior tibiofibular ligament. The two groups were evaluated with Lauge-Hansen classification, the energy of trauma, and the radiologic indices for syndesmotic injury, and were compared each other. Average follow up periods of two groups were 25 and 23 months each. Those who were unstable at stress test during surgery were divided into fragment fixation of anteroinferior tibiofibular ligament avulsion fracture group (8 patients) and transfixation one (11 patients) according to treatment method. Clinical and radiological results at last follow up were also compared.
Results: Fourteen avulsion fractures of anteroinferior tibiofibular ligament were diagnosed by CT only. Incidences of pronation-external rotation injury, high energy trauma, positive radiologic indices for syndesmotic injury were significantly higher in patients with an avulsion fracture of anteroinferior tibiofibular ligament than those without it. Clinical and radiological results were satisfactory in both groups at last follow up, and were not significantly different between them.
Conslusion: In patients who have an ankle fracture by pronation-external rotation injury, high energy trauma, or with positive radiologic indices for syndesmotic injury, CT is useful for diagnosis of an avulsion fracture of anteroinferior tibiofibular ligament. Fragment fixation of anteroinferior tibiofibular ligament avulsion fracture is a useful treatment option for syndesmotic injury.
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KEYWORD
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Anteroinferior tibiofibular ligament, Avulsion fracture, Ankle joint, Computed tomography, Fragment fixation
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