Abstract
BackgroundThis study aimed to retrospectively review the clinical efficacy of open reduction and internal fixation (ORIF) for treatment of high-energy transsyndesmotic ankle fracture dislocation—the “Logsplitter” injury.MethodsBetween December 2006 and December 2014, 41 patients (29 males and 12 females; mean age, 41.46 ± 13.42 years) with Logsplitter injury were treated by ORIF procedure. Patients were grouped as typical injury (mainly vertical axial stress) and untypical injury (mainly rotational stress) according to the injury mechanism and the degree of the talus wedged into the distal tibiofibular joint.ResultsAfter the follow-up of 32.48 ± 24.18 weeks, average American Orthopedic Foot and Ankle Society (AOFAS) score at final follow-up was 78.54 ± 10.66 and the excellent and good rate of 82.9%. Three patients in typical group developed nonunion, and other three cases had infection vs. none in untypical group (both P = 0.053). Burwell-Charnely scoring system revealed anatomic reduction of fracture was achieved in 22 cases, fair reduction in 16 cases, and poor in only 3 cases. Patients in untypical group had better fracture reduction (P = 0.015) and lower incidence rate of posttraumatic ankle arthritis (P = 0.042) than typical cases as well as the range of motion (P < 0.01).ConclusionsThe ORIF may be an optimal approach to treat Logsplitter injuries. Patients with untypical injury had better fracture reduction, range of motion, and low incidence rate of posttraumatic ankle arthritis than those typical ones, and the postoperative outcome was affected by the injury and treatment characteristics.
Highlights
This study aimed to retrospectively review the clinical efficacy of open reduction and internal fixation (ORIF) for treatment of high-energy transsyndesmotic ankle fracture dislocation—the “Logsplitter” injury
Postoperative outcome was associated with the injury and treatment characteristics
In this study, 19 patients and 22 patients were assigned to the typical injury group and untypical injury group according to the injury mechanism and the displacement degree of the talus within the distal tibiofibular joint, respectively
Summary
This study aimed to retrospectively review the clinical efficacy of open reduction and internal fixation (ORIF) for treatment of high-energy transsyndesmotic ankle fracture dislocation—the “Logsplitter” injury. Distal tibiofibular syndesmotic disruption is a common associated injury with ankle fracture dislocations. It usually results from lower energy rotational mechanisms of injury [4]. Cases with high-energy transsyndesmotic ankle fracture dislocations, or “Logsplitter” injuries, have been rarely reported, not to mention the treatment. This injury mechanism may be described as similar ( inverted) to a logsplitter
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