Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.29
Peer-review started: October 9, 2019
First decision: November 13, 2019
Revised: November 28, 2019
Accepted: November 30, 2019
Article in press: November 30, 2019
Published online: January 6, 2020
Processing time: 89 Days and 19 Hours
Posterior malleolar fractures have been reported to occur in < 40% of ankle fractures, which is widely regarded as a critical prognostic factor or outcome indicator following ankle fracture treatment. The morphology of posterior malleolar fractures can be more crucial than fragment size alone for clinical decision making.
The optimal treatment procedures for posterior malleolar fractures remain controversial. The fracture characteristics and recurrent patterns of the posterior malleolar fractures are unclear.
In this study, the authors aimed to reveal the recurrent patterns and characteristics of posterior malleolar fractures by creating fracture maps of the posterior malleolar fractures through the use of computed tomography mapping.
A consecutive series of posterior malleolar fractures was used to create three-dimensional reconstruction images to produce the distribution map of fracture lines through three-dimensional computed tomography mapping in the Mimics and 3-matic software.
Three-dimensional maps showed that the posterior ankle fracture fragments in supination-external rotation grade IV fractures were relatively smaller than those in pronation-external rotation grade IV fractures after posterior malleolus fracture. In addition, the distribution analyses on posterior malleolus fracture lines indicated that supination-external rotation group tended to have higher linear density but more concentrated and orderly distribution fractures compared to pronation-external rotation group.
Fracture maps revealed the fracture characteristics and recurrent patterns of the posterior malleolar fractures, which might help to improve the understanding of ankle fracture.
Multifactor analyses and assessments, larger sample size, prolonged follow-up period and multicenter prospective controlled trials are needed for future investigations.