Clinical Article
Incidence and surgical fixation-related factors of posterior malleolus fracture in treatment of ankle fractures
Mingxin Liao, Yan Wang, Ning Sun, Yong Wu, Ying Li, Xiaofeng Gong
Published 2019-07-15
Cite as Chin J Orthop Trauma, 2019, 21(7): 575-580. DOI: 10.3760/cma.j.issn.1671-7600.2019.07.005
Abstract
ObjectiveTo investigate the incidence and surgical fixation-related factors of posterior malleolus fracture in the treatment of ankle fractures.
MethodsA retrospective study was conducted of the 703 inpatients with ankle fracture at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital from June 1, 2017 to May 31, 2018. Of them, 464 suffered posterior malleolus fracture. The incidence and surgical fixation rate of posterior malleolar fracture were calculated. Of the patients with posterior malleolus fracture, the gender, age, injury energy, Lauge-Hanse classification, Bartonícek classification, talar backward subluxation, fragment area ratio (FAR) of posterior malleolus fracture on X-ray film and CT cross section, fragmental dislocation, and Die-punch fragment were analyzed to screen out the risk factors related to surgical internal fixation for posterior malleolus fracture.
ResultsIn this study, the incidence of posterior malleolus fracture was 66.00% (464/703) and the surgical fixation rate 43.97% (204/464). The gender, age, injury energy, Lauge-Hanse classification, direction of talar subluxation and displacement of Die-punch fragments were not the risk factors related to the surgical internal fixation for posterior malleolus fracture (P>0.05) while the Bartonícek classification, talar backward subluxation, FAR of posterior malleolus fracture on X-ray film and CT cross section, lateral fragmental displacement and Die-punch fragment were the risk factors related to the surgical internal fixation for posterior malleolus fracture (P<0.05). Logistic regression analysis indicated that the talar backward subluxation (OR=5.580, 95% CI:1.623~19.181, P=0.006) and the FAR ≥15% on CT cross section (OR=9.103, 95% CI: 3.342~24.800, P=0.000) were independent risk factors for surgical internal fixation of posterior malleolus fracture.
ConclusionsThe incidence and surgical fixation rate of posterior malleolar fracture are very high. The talar backward subluxation and the fragment area ratio ≥15% on CT cross-section are independent risk factors for surgical internal fixation of posterior malleolus fracture.
Key words:
Ankle; Posterior malleolus; Fractures, bone; Fracture fixation; Related factors
Contributor Information
Mingxin Liao
Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100035, China (Liao Mingxin is working at The First Nanping Hospital Affiliated to Fujian Medical University, Nanping 353000, Fujian, China)
Yan Wang
Ning Sun
Yong Wu
Ying Li
Xiaofeng Gong
