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Review
. 2021 Mar 18;12(3):129-139.
doi: 10.5312/wjo.v12.i3.129.

Advantages of preoperative planning using computed tomography scan for treatment of malleolar ankle fractures

Luigi Tarallo  1 , Gian Mario Micheloni  2 , Michele Mazzi  3 , Arturo Rebeccato  3 , Michele Novi  2 , Fabio Catani  2
Affiliations
Review

Advantages of preoperative planning using computed tomography scan for treatment of malleolar ankle fractures

Luigi Tarallo et al. World J Orthop. .

Abstract

Malleolar ankle fractures have been classified using plain radiographs, and there is no consensus regarding the role of computed tomography (CT) scans in preoperative planning. We analyzed critical aspects, such as limits of standard radiographs, types of injury, classification methods and cost/benefit evaluations. CT scans allow a 3D analysis of the fracture to be obtained and consequently assess the indication for surgical procedure, surgical access and the type of fixation devices required. This exam is useful for detecting lesions that may go unnoticed on radiographs and will help surgeons to clarify the pathoanatomy of ankle fractures. According to Arbeitsgemeinschaft fur Osteosynthesefragen/ Orthopaedic Trauma Association (AO/OTA) classification, CT scan is recommended in medial malleolar fractures with vertical rim, type 44B fractures with posterior malleolar involvement and all type 44C fractures (according to AO/OTA). Also Tillaux-Chaput fractures (43-B1 according to AO/OTA), malleolar fractures in the presence of distal tibial fractures (43 according to AO/OTA) and distal tibia fractures in adolescents should be studied with CT scans.

Keywords: Computed tomography scan; Imaging; Malleolar fractures; Planning; Trauma.

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Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Transsyndesmotic fracture (44-B3). A: Anteroposterior; B: Lateral view.
Figure 2
Figure 2
Computed tomography scans of the coronal plane and sagittal plane allow detection for the best screws direction. A: Coronal plane; B: Sagittal plane.
Figure 3
Figure 3
Postoperative X-rays in the anteroposterior and lateral view. Fractures treated with plate and screw fixation. A: Anteroposterior view; B: Lateral view.
Figure 4
Figure 4
Suprasyndesmotic fracture (44-C2). A: Anteroposterior; B: Lateral view.
Figure 5
Figure 5
Computed tomography scans shows the involvement of the Tillaux-Chaput fragment. A and B: Tillaux-Chaput fragment.
Figure 6
Figure 6
Ankle fracture in adolescent. A: Anteroposterior view; B: Lateral view.
Figure 7
Figure 7
Computed tomography scan shows a triplane fracture. A: Coronal plane; B: Axial plane; C: Sagittal plane.
Figure 8
Figure 8
Postoperative X-rays in the anteroposterior view. Fractures treated with screws.
See this image and copyright information in PMC

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