Weightbearing vs Gravity Stress Radiographs for Stability Evaluation of Supination-External Rotation Fractures of the Ankle

Foot & Ankle International
Angela SeidelMartin Weber

Abstract

Isolated lateral malleolar fractures may result from a supination-external rotation (SER) injury of the ankle. Stable fractures maintain tibiotalar congruence due to competent medial restraints and can be treated nonoperatively with excellent functional results and long-term prognosis. Stability might be assessed with either stress radiographs or weightbearing radiographs. A consecutive series of patients with closed SER fractures (presumed AO 44-B1) were prospectively enrolled from 2008 to 2015. Patients with clearly unstable fractures (medial clear space more than 7 mm) on the initial nonweightbearing radiograph were excluded and operated on. All other patients were examined with a gravity stress and a weightbearing anteroposterior radiograph. Borderline instability of the fracture was assumed when the medial clear space was 4 to 7 mm. Those were treated nonoperatively. Of 104 patients with isolated lateral malleolar fractures of the SER type, 14 patients were treated operatively because of clear instability (displacement) on the initial radiographs. Of the nonoperative patients, 44 patients demonstrated borderline instability on the gravity stress but stability on the weightbearing radiograph ("gravity borderline"); the rema...Continue Reading

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May 16, 2018·The Journal of Bone and Joint Surgery. American Volume·Sheldon S LinMichael Yeranosian
Oct 21, 2017·Der Unfallchirurg·Kajetan KlosMatthias Knobe
Jul 25, 2019·Journal of Orthopaedic Trauma·Chad P ColesUNKNOWN Orthopaedic Trauma Associationʼs Evidence-Based Quality Value and Safety Committee
Oct 11, 2019·Foot & Ankle International·Isabel RosaJosé Guimarães Consciência
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Jan 23, 2020·Der Unfallchirurg·Konrad KaminStefan Rammelt
Jul 15, 2020·Foot & Ankle International·Kimberly K BroughtonJohn Y Kwon
Feb 11, 2021·Der Unfallchirurg·Sabine Ochman, Michael J Raschke
Jan 1, 2021·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Ashley E LevackDean G Lorich
Sep 15, 2020·Journal of Orthopaedic Trauma·Sini KarkkolaHannu-Ville Leskelä
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