Anatomy and classification of the posterior tibial fragment in ankle fractures

Bartoníček, Jan; Rammelt, Stefan; Kostlivý, Karel; Vaněček, Václav; Klika, Daniel; Trešl, Ivo

doi:10.1007/s00402-015-2171-4

Cited by 206 publications

(206 citation statements)

References 29 publications

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“…There is consensus that the true size and geometry of the fragment, specifically its medial propagation, and intercalary fragments may be diagnosed only by CT scanning [9,11,20,51,64,65,79]. CT scans taken in the transverse and sagittal planes should be combined with 3D CT reconstruction in order to get an accurate anatomical picture [9].…”

Section: Diagnosismentioning

confidence: 99%

“…CT scans taken in the transverse and sagittal planes should be combined with 3D CT reconstruction in order to get an accurate anatomical picture [9]. Highly instructive in this respect is a 3D view of the distal aspect from below with subtraction of the talus.…”

Section: Diagnosismentioning

confidence: 99%

“…Bartoníček and Rammelt [9] in 2015 analyzed 141 consecutive individuals with an ankle fracture or fracture-dislocation of types Weber B or Weber C and evidence of a PM fragment in standard radiographs. All patients underwent CT scanning in transverse, sagittal and frontal planes.…”

Section: Classificationmentioning

confidence: 99%

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Posterior malleolar fractures of the ankle

Bartoníček

Rammelt

Tuček

et al. 2015

Eur J Trauma Emerg Surg

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Despite an increasing awareness of injuries to PM in ankle fracture-dislocations, there are still many open questions. The mere presence of a posterior fragment leads to significantly poorer outcomes. Adequate diagnosis, classification and treatment require preoperative CT examination, preferably with 3D reconstructions. The indication for surgical treatment is made individually on the basis of comprehensive assessment of the three-dimensional outline of the PM fracture and all associated injuries to the ankle including syndesmotic instability. Anatomic fixation of the avulsed posterior tibiofibular ligament will contribute to syndesmotic stability and restore the integrity of the incisura tibiae thus facilitating anatomic reduction of the distal fibula. A necessary prerequisite is mastering of posterolateral and posteromedial approaches and the technique of direct reduction and internal fixation. Further clinical studies with higher numbers of patients treated by similar methods and evaluation of pre- and postoperative CT scans will be necessary to determine reliable prognostic factors associated with certain types of PM fractures and associated injuries to the ankle.

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Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

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Posterior malleolar fractures of the ankle

Bartoníček

Rammelt

Tuček

et al. 2015

Eur J Trauma Emerg Surg

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“…Accurate reduction cannot be assured, however, and an intercalated fragment, which would only be seen on a CT scan, is one possible reason for this. 23 Also, if the lateral malleolus fracture is fixed in isolation, because it is attached by the posteroinferior tibiofibular ligament to the posterior malleolus fragment, the latter may displace, and even small degrees of displacement will affect the healing 'length' of the posterior syndesmotic osseo-ligamentous component and, ultimately, result in posterolateral talar instability.…”

Section: Cite This Articlementioning

confidence: 99%

“…Bartoniček et al 3,10,23 used more advanced CT reconstructions to classify posterior malleolus fractures in 141 patients. Their system has four main types.…”

Section: Cite This Articlementioning

confidence: 99%

Posterior malleolus fractures

Solan

Sakellariou

2017

The Bone & Joint Journal

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The posterior malleolus component of a fracture of the ankle is important, yet often overlooked. Pre-operative CT scans to identify and classify the pattern of the fracture are not used enough. Posterior malleolus fractures are not difficult to fix. After reduction and fixation of the posterior malleolus, the articular surface of the tibia is restored; the fibula is out to length; the syndesmosis is more stable and the patient can rehabilitate faster. There is therefore considerable merit in fixing most posterior malleolus fractures. An early postoperative CT scan to ensure that accurate reduction has been achieved should also be considered. Cite this article:

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3D‐printing polylactic acid/hydroxyapatite fracture internal fixation plates for bone repair

Xia

Zhang

et al. 2022

J of Applied Polymer Sci

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Fracture internal fixation plates are the most common implants in internal fixation and have been applied to fix fractures for over a hundred years. Plates of metal material remain the gold standard. However, they are not the ideal bone plate considering the stress shielding induced by the high elastic modulus and biomechanical mismatch with bone. PLA fracture internal fixation plates present the advantages of matching with the elastic modulus of the bone and absorbable properties but are limited by poor toughness and acidic degradation. Degradable bone plates composed of polylactic acid/hydroxyapatite (PLA/HA) composite were prepared by fused deposition modeling, which had higher bending strength and compressive strength than that of pure PLA. The hydrophilicity of PLA/HA composite was improved by the addition of HA, it was beneficial to the adhesion of cells on the surface of the composite. The results of in vitro degradability showed that the addition of HA can effectively neutralize the acidity generated by PLA degradation. Meanwhile, the addition of HA can improve the cell affinity to promote the adhesion and growth of MC3T3‐E1 cells on the surface of the composites. Consequently, the PLA/HA composite shows a good potential as a bone plate to fix bone fractures.

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Anatomy and classification of the posterior tibial fragment in ankle fractures

Cited by 206 publications

References 29 publications

Posterior malleolar fractures of the ankle

Posterior malleolar fractures of the ankle

Posterior malleolus fractures

3D‐printing polylactic acid/hydroxyapatite fracture internal fixation plates for bone repair

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