Imaging And Clinical Correlation Of Medial And Inferior Tibia Combined With Posterior Malleolus Fracture

Background:Aposterior ankle fracture is a common component of ankle fractures.It comes in many shapes.Fractures range from small posterolateral avulsion fragments to large displaced one.The integrity of the posterior malleolus and the superior inferior tibiofibular posterior ligament is important for tibial distance load transfer,posterior stability of the talus,and rotational stability of the ankle joint.Spiral tibial shaft fracture combined with ipsilateral posterior malleolar fracture(TSPMF)is more rare than simple ipsilateral posterior malleolar fracture(PMF)in ankle joint fracture in adults.And the concomitant posterior malleolar fracture is mostly undisplaced and has a high occult.For such posterior ankle fractures,the detection rate of X-ray is low and the misdiagnosis rate is high.It may have a negative impact on the prognosis of patients if be misdiagnosed.The purpose of this study was to explore the correlation between the incidence and imaging manifestations of various types of tibial shaft fractures combined with ankle fractures,and to explore the diagnostic value of CT for this type of fractures.Methods: Atotal of 134 adult patients with tibial shaft fractures were selected,including 98 males and 36 females,with an average age of 47.3±20.17 years,51 cases of left fracture and 83 cases of right fracture.Inclusion and exclusion criteria were used.All the patients were examined by preoperative X-ray plain film and 3d CT reconstruction of the ankle joint.The causes of injury were as follows:And strain 93 cases and traffic injury 37 cases,play the parts in 5 cases,according to the patients with posterior ankle fracture condition such as grouping,and through the imaging measurement stem fracture of tibial fracture height,fracture morphology and fracture line line direction,type,degree of shift after ankle fracture,fracture block size,the application of SPSS 21.0 statistical analysis,compare the differences between two groups,clear after ankle fracture,the important factors and calculating the missed diagnosis of X-ray in the type of fracture,predict what type dry tibia fracture need more ankle CT examination,to reduce the missed diagnosis of ankle fractures after.Results: 46(34.3%)patient had posterior ankle fractures of 134 patients with tibial shaft fractures.Two groups of age,sex,one side has no obvious difference,but the tibia fracture morphology,fracture location,fibula fracture height all have significant differences.X-ray for each type of tibia fractures after ankle fracture detection rate have significant difference.The tibia and fibula fracture position,fracture form of integrity or not is an important factor to cause after ankle fracture,tibia fracture condition is closely related to the relevant after ankle fracture.Conclusions: tibial shaft fractures are often associated with posterior malleolus fractures,especially spiral injuries of the middle and lower tibia.For this type of fracture,X-ray misdiagnosis rate is high and should be highly valued in clinical work,while CT examination is helpful for the identification of most posterior ankle fractures.Combined with medical history and physical examination,three-dimensional CT reconstruction of the ankle joint should be taken when necessary for further diagnosis.