The Use of Sonography for Evaluation of the Integrity and Healing Process of the Tibiofibular Interosseous Membrane in Ankle Fractures

Abstract

This study evaluates the value of sonography in the diagnosis of the rupture and healing process of the interosseous membrane in Weber type B and C ankle fractures. In 90 such fractures a rupture of the interosseous membrane was intraoperatively observed in 35 cases (38.8%). All Weber type C fractures showed a rupture of the interosseous membrane, whereas only 23% of the Weber type B fractures were associated with a rupture of the interosseous membrane (p < 0.001). In the vast majority of the cases (77%), particularly in all Weber type B fractures (p < 0.01), the rupture of the interosseous membrane extended above the proximal fracture line of the fibula. By means of sonography, in the acute posttrauma period a rupture of the interosseous membrane was found in 37.4% of the cases. Thus, in our series the results of sonography and the operative findings coincided in 88.6% of the cases concerning location, type, and extent. Sonography was performed by three unbiased observers, and the results were compared with the intraoperative findings. Thus, the sensitivity of the sonography in the diagnosis of the rupture of the interosseous membrane was 88.8%, the diagnostic value of the method 92.2%, and specificity 94.5%. The sonographic findings of the healing process of the interosseous membrane were in absolute (100%) agreement with the intraoperative observations at the time of removal of the osteosynthesis material. Complete healing occurred within 3-5 months after trauma in 70% of the cases of ruptured interosseous membrane.(ABSTRACT TRUNCATED AT 250 WORDS)