Three radiographic parameters correlate with computed tomography displacement in transitional ankle fractures

Area of Science:

• Orthopedic Surgery
• Pediatric Radiology
• Medical Imaging Analysis

Background:

• Transitional ankle fractures, including Tillaux and triplane types, are common in pediatric patients.
• Accurate assessment of fracture displacement is crucial for appropriate management.
• Computed tomography (CT) provides detailed displacement information, but its selective use is desirable.

Purpose of the Study:

• To evaluate the predictive ability of standard radiographic measurements for fracture displacement in transitional ankle fractures.
• To determine which radiographic parameters correlate with displacement as seen on CT scans.

Main Methods:

• Retrospective review of 61 pediatric patients with Tillaux or triplane ankle fractures.
• Independent evaluation of radiographs and CT scans by three raters.
• Calculation of interrater reliability using intraclass correlation coefficients (ICCs).
• Spearman correlation analysis to assess relationships between radiographic and CT measurements.

Main Results:

• Good interobserver agreement was achieved for most measurements (ICC > 0.6).
• Radiographic anteroposterior views showed lower reliability compared to mortise and lateral views.
• Significant correlations were found between CT displacement and tibiofibular clear space (mortise view), articular displacement (mortise and lateral views), and epiphyseal displacement (lateral view).

Conclusions:

• Certain radiographic parameters, including tibiofibular clear space and articular/epiphyseal displacement on mortise and lateral views, significantly correlate with CT-measured displacement.
• These radiographic findings can serve as valuable indicators for the judicious selection of CT imaging in pediatric transitional ankle fractures.