A method for detection of lateral malleolar malrotation using conventional fluoroscopy

Area of Science:

• Orthopaedic Surgery
• Radiology
• Biomechanics

Background:

• Ankle syndesmosis injuries often involve rotational malediction of the distal fibula.
• Missed rotational malediction can lead to poor functional outcomes after ankle fractures.
• Accurate assessment of fibular rotation is crucial for effective treatment.

Purpose of the Study:

• To develop and validate new radiographic criteria for detecting distal fibula internal and external rotation.
• To improve the accuracy and inter-observer agreement in assessing fibular rotation using conventional fluoroscopy.

Main Methods:

• Development of novel radiographic criteria for evaluating distal fibula rotation.
• Testing of these criteria on a cadaveric model of Weber C ankle fractures.
• Fixation of the fibula in varying degrees of internal and external rotation within the cadaveric model.

Main Results:

• The new radiographic criteria enhanced orthopaedic trauma surgeons' ability to detect distal fibula rotation.
• Improved accuracy and agreement were observed among surgeons when assessing the degree and direction of fibular rotation.
• The criteria proved effective in a controlled cadaveric setting for identifying rotational malediction.

Conclusions:

• The developed radiographic criteria are effective in improving the assessment of distal fibula rotation in ankle injuries.
• These criteria offer a valuable tool for clinicians to better diagnose and manage rotational malediction in Weber C ankle fractures.
• Enhanced diagnostic accuracy for fibular rotation can contribute to better functional outcomes for patients with ankle syndesmosis injuries.