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KMID : 1130920050090020167
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Journal of Korean Foot and Ankle Society
2005 Volume.9 No. 2 p.167 ~ p.172
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Intra-articular Avulsion Fractures of the Malleolus in Chronic Ankle Pain
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Han Seung-Hwan
Lee Jin-Woo
Kim Sung-Hwan
Kang Eung-Shick
Kim Sung-Jae
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Abstract
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Purpose:We report our results of arthroscopic treatment of symptomatic avulsion fracture of the malleolus in chronic ankle pain, and also analyzed the clinical and radiological features for evaluating the good candidate for arthroscopic treatment.
Material and Methods :Fourteen patients who were diagnosed with intra-articular avulsion fractures of the malleolus received arthroscopic surgery and were followed up for at least a year. The clinical and radiological characters including MRI and arthroscopic findings were reviewed. Clinical assessments were done according to the AOFAS score system.
Results: There was a history of inversion type of the injury in most cases and local tenderness of lesion site was a unique. MRI study showed thickened anterior talofibular ligament (ATFL) in 8 cases (57%) and discontinued ATFL in 3 cases (21%). Enhanced signal surrounding soft tissue corresponding to synovial inflammation and impingement was found in 12 cases (86%). Preoperative score of all patients were 74.0±5.5, which improved to 89.3±6.7 at the follow-up after the treatment (P<0.001).
Conclusions:Most patients had history of injury and localized tenderness in the area coinciding with radiological findings. Thickened ATFL and contrast enhancement around the ossicle were frequently found. Symptomatic avulsion fractures of the malleolus associated with the clinical and radiological findings above could be a good candidate for arthroscopic treatment.
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KEYWORD
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Ankle, Malleolus, Loose body, Avulsion fractures, Arthroscopic treatment
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