Related Experiment Video
Updated: Jun 18, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
CT assessment of lateral talar displacement in supination-external rotation ankle fractures: Correlation with
Background:
Conventional radiographs often fail to accurately quantify lateral talar displacement in supination-external rotation (SER) ankle fractures.
Purpose:
This study evaluated a CT-derived parameter-lateral talar displacement (LTD)-as an objective surgical indicator by assessing its correlation with treatment decisions.
Study Design:
Retrospective comparative study.
Methods:
We retrospectively reviewed CT images of 124 SER ankle fractures. Patients were categorized into conservative (n=44) and surgical (n=80) treatment groups, with 80 non-fracture individuals serving as normal controls. LTD was measured on coronal CT images at the level of the fibular notch. Inter- and intraobserver reliability were assessed using intraclass correlation coefficients. Group comparisons were performed using one-way analysis of variance, and receiver operating characteristic (ROC) curve analysis determined the optimal threshold for predicting surgical intervention.
Results:
LTD demonstrated excellent interobserver and intraobserver reliability. Mean LTD was -1.0 ± 0.7 mm in normal controls, -0.9 ± 0.7 mm in the conservative group, and 3.5 ± 3.0 mm in the surgical group (p < 0.001). LTD increased progressively with SER stage: stage 2, -0.8 ± 0.8 mm; stage 3, 0.4 ± 1.5 mm; stage 4, 4.0 ± 3.1 mm (p < 0.001). ROC analysis yielded an area under the curve of 0.976 (95% CI 0.952-1.000), with an LTD threshold > 1 mm providing 86% sensitivity and 96% specificity for predicting surgical intervention.
Conclusions:
LTD is a reliable parameter for quantifying lateral talar displacement. A threshold greater than 1 mm accurately identifies fractures that require surgical stabilization and serves as a valuable adjunct to conventional radiographic assessment.
Related Concept Videos
01:10Ankle Joint
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...