Abstract
Purpose: The ankle joint has a complex anatomy structure with many causative factors and various injury mechanisms, and the clinical presentation of ankle fractures is diverse. This study aimed to analyze the characteristics of ankle fractures by applicating three-dimensional fracture line mapping technique. Methods: A retrospective study was conducted on 228 patients with ankle fractures. Three-dimensional reconstruction was performed by CT images and the fracture reconstruction model was superimposed onto a standard model of the tibiofibula for fracture line drawing. Then the fracture lines were converted into a three-dimensional coordinate point data set. And the fracture line maps as well as the fracture line heat maps were generated in 3-Matic software and Unigraphics NX software, respectively. Results: The dense area of the fibular fracture lines was located above the tibiofibular joint ligament and wrapped obliquely around the distal fibula from the anterior edge of the fibular neck. The fibular fracture line could be divided into three categories according to the degree of denseness. The dense area of the tibial fracture line is located within the anterior tibial fornix, the anterolateral corner, and the fibular notch. The tibial fracture lines can be classified into four categories according to the density of the fracture lines. The combined medial malleolus + posterior malleolar fracture line situation was found to be not encompassed by the existing AO and Lauge-Hansen (LH) classification systems according to this classification. Conclusion: The 3D fracture line mapping technique can better reflect the distribution of ankle fracture lines and could help to establish a new ankle fracture typing system in the future.
Highlights
Ankle fractures account for approximately 3.9% of total body fractures (Koval et al, 2005), of which the incidence has a tendency to increase year by year with the aging process of the population and social development
They classified posterior malleolar fractures into three types, type I: the fracture fragment was wedge-shaped and involved the posterior external angle of the distal tibial articular surface; type II: the fracture line extended from the fibular notch of the distal tibia to the medial malleolar; type III: small shell type, where one or more small shell-shaped bone fragments were fractured at the posterior edge of the distal tibia
Mangnus et al (Mangnus et al, 2015), on the other hand, qualitatively analyzed the morphology of posterior malleolar fractures based on the Haraguchi classification and divided the posterior malleolar fracture line into two categories: posterior external oblique (Haraguchi type I and III, both of which were fractures of different degrees caused by the same extensive force) and transverse
Summary
Ankle fractures account for approximately 3.9% of total body fractures (Koval et al, 2005), of which the incidence has a tendency to increase year by year with the aging process of the population and social development. How to comprehensively and accurately assess ankle fractures, understand fracture injury mechanisms and select appropriate treatment methods are very important in clinical practice. As the main method to describe the fracture injury pattern, fracture classification is the most scientific, simple, and practical method to analyze the fracture injury mechanism, guide the treatment, and judge the prognosis, which plays a vital role in clinical practice. With the popularization of CT and three-dimensional (3D) CT technology in recent years, the research on ankle fractures in the industry has deepened, and the understanding of fracture morphology, fracture line distribution, fracture pattern, and fracture injury mechanism has become more advanced. Unlike the traditional posterior malleolus fracture, the fracture fragment was much bigger and proximally displaced, and the articular surface was collapsed without comminuted fracture fragment, which cannot be explained by the existing ankle fracture classification
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
