Anterior Tibiofibular Ligament Avulsion Fracture in Weber Type B Lateral Malleolar Fracture

2002 ◽  
Vol 52 (4) ◽  
pp. 655-659 ◽  
Author(s):  
Jong-Woong Park ◽  
Sung-Kon Kim ◽  
Jun-Seok Hong ◽  
Jung-Ho Park
Keyword(s):  
Avulsion Fracture ◽  
Type B ◽  
Malleolar Fracture ◽  
Tibiofibular Ligament ◽  
Weber Type

scholarly journals Reduction and fixation of anterior inferior tibiofibular ligament avulsion fracture without syndesmotic screw fixation in rotational ankle fracture

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051988255
Author(s):  
Kee Jeong Bae ◽  
Seung-Baik Kang ◽  
Jihyeung Kim ◽  
Jaewoo Lee ◽  
Tae Won Go
Keyword(s):  
Fracture Fixation ◽  
Ankle Fracture ◽  
Avulsion Fracture ◽  
Screw Fixation ◽  
Malleolar Fracture ◽  
Tibiofibular Ligament ◽  
Radiographic Parameters ◽  
Syndesmotic Screw ◽  
Anterior Inferior Tibiofibular Ligament ◽  
American Orthopaedic

Objective We aimed to present the radiographic and functional outcomes of anatomical reduction and fixation of anterior inferior tibiofibular ligament (AITFL) avulsion fracture without syndesmotic screw fixation in rotational ankle fracture. Methods We retrospectively reviewed 66 consecutive patients with displaced malleolar fracture combined with AITFL avulsion fracture. We performed reduction and fixation for the AITFL avulsion fracture when syndesmotic instability was present after malleolar fracture fixation. A syndesmotic screw was inserted only when residual syndesmotic instability was present even after AITFL avulsion fracture fixation. The radiographic parameters were compared with those of the contralateral uninjured ankles. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were assessed 1 year postoperatively. Results Fifty-four patients showed syndesmotic instability after malleolar fracture fixation and underwent reduction and fixation for AITFL avulsion fracture. Among them, 45 (83.3%) patients achieved syndesmotic stability, while 9 (16.7%) patients with residual syndesmotic instability needed additional syndesmotic screw fixation. The postoperative radiographic parameters were not significantly different from those of the uninjured ankles. The mean AOFAS score was 94. Conclusion Reduction and fixation of AITFL avulsion fracture obviated the need for syndesmotic screw fixation in more than 80% of patients with AITFL avulsion fracture and syndesmotic instability.

Syndesmosis Injury Associated with the Weber Type B Lateral Malleolar Fracture

2008 ◽  
Vol 43 (3) ◽  
pp. 359
Author(s):  
Si Young Park ◽  
Sang Won Park ◽  
Seung Beom Hahn ◽  
Woong Kyo Jung ◽  
Keun Seok Choi ◽  
...  
Keyword(s):  
Type B ◽  
Malleolar Fracture ◽  
Syndesmosis Injury ◽  
Weber Type

scholarly journals New “Freer test” for assessment of syndesmotic diastasis -Cadaveric study

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0029
Author(s):  
Jinsu Kim ◽  
Young-uk Park ◽  
Kyung-tai Lee ◽  
Kiwon Young ◽  
Sang Lee
Keyword(s):  
Diagnostic Value ◽  
Type B ◽  
Interosseous Ligament ◽  
Firm Structure ◽  
Tibiofibular Ligament ◽  
Fibular Fracture ◽  
Probe Test ◽  
Anterior Inferior Tibiofibular Ligament ◽  
Weber Type ◽  
Fibular Fixation

Category: Sports Introduction/Purpose: Syndesmotic stability is usually assessed arthroscopically by an arthroscopic probe insertion between the anterolateral tibio-fibular recess. This probe test can predict the syndesmotic instability, however, is difficult to determine syndesmotic fixation. The syndesmosis has dynamic motion and fairly firm structure, 2 mm thin probe cannot make syndesmotic dynamic diastasis. We proposed a new “Freer test” for diagnosis of syndesmosis injury which performed to insert a 2 mm diameter freer elevator between tibio-fibular lateral gutter while keeping the ankle at the plantigrade. The purpose of the present study was to evaluate the diagnostic value of freer test for anterior inferior tibiofibular ligament (AITFL) complete tear, interosseous ligament (IOL) tear and Weber type B fibular fracture. Methods: Ten fresh ankle cadaveric specimens were used. Operative procedures progressed as below; firstly, exposed antero-lateral ankle joint with direct lateral longitudinal incision, incised AITFL, incised IOL, performed Weber type B osteotomy at fibular, fixed the osteomized fibular with 8-hole locking plate and fixed the AITFL with suture anchors. In each procedure, freer tests with ankle dorsiflexion (DF, plantigrade) and plantarflexion (PF) were performed with freer elevator linked 3 kgf compression gauge. A negative test was defined as the freer did not insert with a more than 3 kgf. A positive test was defined lesser than 3 kgf, and measured the force at the insertion. Results: All freer test was negative with DF before procedures. Six ankles with PF were positive with average 1.5 kgf. All freer test positive has shown after AITFL cutting in DF, PF(mean 1.76 kgf, 1.19 kgf). After IOL cutting, all freer tests were positive in DF, PF(mean 1.46, 0.79 kgf). After fibular osteotomy, all freer tests were positive in DF, PF (mean 0.83,0.18 kgf). After fibular fixation with plate, all freer tests were positive in DF, PF (mean 1.26, 0.97 kgf). After syndesmotic fixation with anchors, 8 freer tests were positive in DF. 2 negative in PF, 4 negative in PF and 6 positive in PF. 2 positive in DF had partial breakage on anchor footprint due to weak bone. Conclusion: The “freer test” is useful diagnostic tool which test positive means AITFL rupture.

Single Hemicerclage for Lateral Type B Malleolar Fracture - A Novel, Minimal and Reliable Osteosynthesis

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 283-288
Author(s):  
Maurer ◽  
Stamenic ◽  
Stouthandel ◽  
Ackermann ◽  
Gonzenbach
Keyword(s):  
Ankle Joint ◽  
Weight Bearing ◽  
Fracture Type ◽  
Type B ◽  
Malleolar Fracture ◽  
Metallic Wire ◽  
Long Term Outcome ◽  
X Ray ◽  
Upper Ankle Joint ◽  
Upper Ankle

Aim of study: To investigate the short- and long-term outcome of patients with isolated lateral malleolar fracture type B treated with a single hemicerclage out of metallic wire or PDS cord. Methods: Over an 8-year period 97 patients were treated with a single hemicerclage for lateral malleolar fracture type B and 89 were amenable to a follow-up after mean 39 months, including interview, clinical examination and X-ray controls. Results: The median operation time was 35 minutes (range 15-85 min). X-ray controls within the first two postoperative days revealed an anatomical restoration of the upper ankle joint in all but one patient. The complication rate was 8%: hematoma (2 patients), wound infection (2), Sudeck's dystrophy (2) and deep vein thrombosis (1). Full weight-bearing was tolerated at median 6.0 weeks (range 2-26 weeks). No secondary displacement, delayed union or consecutive arthrosis of the upper ankle joint was observed. All but one patient had restored symmetric joint mobility. Ninety-seven percent of patients were satisfied or very satisfied with the outcome. Following bone healing, hemicerclage removal was necessary in 19% of osteosyntheses with metallic wire and in none with PDS cord. Conclusion: The single hemicerclage is a novel, simple and reliable osteosynthesis technique for isolated lateral type B malleolar fractures and may be considered as an alternative to the osteosynthesis procedures currently in use.

scholarly journals Reporting Discrepancy Resolved by Findings and Time in 2947 Emergency Department Ankle X-rays

2019 ◽  
Vol 49 (4) ◽  
pp. 601-611 ◽  
Author(s):  
Thomas James York ◽  
P. J. Jenkins ◽  
A. J. Ireland
Keyword(s):  
Emergency Department ◽  
Working Hours ◽  
High Standard ◽  
Causative Factor ◽  
X Rays ◽  
Type B ◽  
Complete Dataset ◽  
Specific Finding ◽  
Weber Type ◽  
Major Discrepancy

Abstract Aims To identify common errors in ankle X-ray reporting between initial interpretation and final assessment at the virtual fracture clinic. Also, to assess time of initial reporting as a causative factor for discrepancy. Methods Two thousand nine hundred forty-seven final reports were reviewed by standard of agreement to the initial interpretation. Where discrepancy was found, it was classified and collated by specific finding. Comparison was made between reports with discrepancy and the complete dataset, allowing rates of error by finding to be established. The reports containing discrepancy were further classified by time period, this was compared against an expected value to establish if initial reporting outside of routine working hours was as accurate as that conducted within routine working hours. Results 94.4% of reports were in agreement with the initial interpretation, 2.9% contained minor discrepancy, and 2.7% major discrepancy. In 45.6% of reports there was no radiologically observable injury. 16.4% of reports contained a lateral malleolar fracture, most commonly Weber type B. 40.0% of all navicular fractures, and 33.3% of all cuboidal fractures were not commented upon in the initial reporting. Lower rates of more frequently observed findings were missed with 2.5% of Weber type B fractures not commented upon. An increased proportion of major discrepancy reports were generated from 00:00 to 07:59 (expected = 15.0%, observed = 22.2%; p = 0.07908). Similarly, a greater than expected number of minor discrepancy reports were found between 20:00 and 23:59 (expected = 18.0%, observed = 34.1%, p = 0.00025). Conclusions The initial reporting of ankle X-rays in the emergency department is performed to a high standard, however serious missed findings emphasise the need for timely senior review. Reporters should increase their awareness of navicular, cuboid, talar, and Weber A fractures which were missed at disproportionate rates. This study also finds evidence to support increased rates of error in initial reporting of ankle X-rays outside of normal working hours (17:00–07:59), particularly with a significantly increased rate of minor discrepancy seen from 20:00 to 23:59.

The Treatment of Danis-Weber Type B Fractures of the Distal Fibula by Multiple Kirschner Wires Fixation

2000 ◽  
Vol 13 (3) ◽  
pp. 529 ◽  
Author(s):  
Ho Yoon Kwak ◽  
Baik Young Song ◽  
Sang Wook Bae ◽  
Nam Hong Choi ◽  
Jin Young Kim
Keyword(s):  
Type B ◽  
Kirschner Wires ◽  
Distal Fibula ◽  
Weber Type

scholarly journals Posterior tibialis tendon rupture associated with closed medial malleolus fracture and avulsion of anterior talofibular ligament: A case report and review of the literature

2018 ◽  
Vol 25 (4) ◽  
pp. 232-235 ◽  
Author(s):  
Amir Reza Vosoughi ◽  
Hamid Ravanbod ◽  
Mark Gilheany ◽  
Mohammad Ali Erfani ◽  
Kamran Mozaffarian
Keyword(s):  
Tendon Rupture ◽  
Avulsion Fracture ◽  
Traumatic Rupture ◽  
Medial Malleolus ◽  
Anterior Talofibular Ligament ◽  
High Velocity Impact ◽  
Review Of The Literature ◽  
Malleolar Fracture ◽  
Case Presentation ◽  
Medial Malleolus Fracture

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 complete posterior tibialis tendon (PTT) rupture and anterior talofibular ligament avulsion fracture from the talus in association with medial malleolus fracture in a 30-year-old male motorcyclist without any open wounds. Discussion: We believe this to be the first reported injury of this type in the literature. Closed ankle fractures may obscure surrounding tendon rupture and the clinician may be tempted to focus on the osseous injuries rather than the significance of associated soft tissue injures. Conclusion: This particular case demonstrates the importance of assessing for PTT injury in situations where high velocity impact to the ankle results in malleolar fracture.

scholarly journals Diagnosis of tibiofibular syndesmosis instability in Weber type B malleolar fractures

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052093975
Author(s):  
Qiang Huang ◽  
Yongxing Cao ◽  
Chonglin Yang ◽  
Xingchen Li ◽  
Yangbo Xu ◽  
...  
Keyword(s):  
Ankle Fractures ◽  
Preoperative Imaging ◽  
Diagnostic Efficiency ◽  
Tibiofibular Syndesmosis ◽  
Type B ◽  
X Ray ◽  
Malleolar Fractures ◽  
Distal Tibiofibular Syndesmosis ◽  
Arthroscopic Findings ◽  
Weber Type

Objective This study was performed to analyze the clinical value of X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) examinations for the diagnosis of distal tibiofibular syndesmosis injuries in Weber type B ankle fractures with reference to the ankle arthroscopic findings. Methods This retrospective clinical study involved 52 patients with type B ankle fractures from August 2014 to January 2018. We analyzed the patients’ preoperative imaging data and judged the stability of the distal tibiofibular syndesmosis using X-ray, CT, and MRI examinations. We also evaluated the syndesmosis stability with arthroscopy both statically and dynamically. Results With the arthroscopic findings as the standard, the sensitivity of X-ray for diagnosing syndesmosis instability was 52.8%, the specificity was 100%, and the diagnostic efficiency was 67.3%. The sensitivity of CT for diagnosing syndesmosis instability was 77.8%, the specificity was 100%, and the diagnostic efficiency was 84.6%. The sensitivity of MRI for diagnosing syndesmosis instability was 100%, the specificity was 81.3%, and the diagnostic efficiency was 94.2%. Conclusion This study suggests that an arthroscopic examination may be recommended when the X-ray or CT features are different from the MRI findings while diagnosing tibiofibular syndesmosis instability in Weber type B malleolar fractures.

Sign in / Sign up

Export Citation Format

Share Document