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Talus Visualization in Ankle Fractures: How Much Are We Really Seeing?
Nathaniel B Hinckley1, Jeffrey D Hassebrock1, Phillip J Karsen1
1Department of Orthopaedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Orthopaedic Journal of Sports Medicine
|January 13, 2022
Summary
Open ankle fracture surgery reveals only a small portion of the talus, potentially missing intra-articular damage. Arthroscopic evaluation may be necessary for comprehensive assessment of ankle fractures.
Area of Science:
- Orthopedic Surgery
- Anatomy
- Biomechanics
Background:
- Persistent pain after ankle fractures can stem from intra-articular pathology in up to 65% of cases.
- Understanding the extent of surgical visualization is crucial for addressing these issues.
Purpose of the Study:
- To determine the percentage of the talus's weightbearing surface visible during open approaches for supination external rotation bimalleolar ankle fractures.
- Quantify talar surface visualization in a simulated fracture model.
Main Methods:
- A descriptive laboratory study using 4 cadaveric ankle specimens.
- Simulated supination external rotation bimalleolar ankle fractures.
- Measured visible talar cartilage area via open approach and compared it to the total weightbearing surface.
Main Results:
- The mean total weightbearing surface area of the talus was 14.0 cm².
- The mean visible area through an open approach was 2.1 cm².
- This represents only 14.8% of the total talar surface visualized.
Conclusions:
- Open surgical approaches for bimalleolar ankle fractures provide limited visualization of the talus's weightbearing surface.
- The limited exposure may lead to missed intra-articular pathologies.
- Arthroscopic evaluation could be beneficial for assessing and treating osteochondral lesions in these fractures.
