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Using tomography to diagnose occult ankle fractures
K Ho1, D G Connell, D L Janzen
1Department of Emergency Medicine, Vancouver Hospital, British Columbia, Canada.
Annals of Emergency Medicine
|May 1, 1996
Summary
Occult ankle fractures occur in at least 1% of ankle injuries. Radiographic ankle effusions correlate with occult fractures in 35-85% of severe injuries, suggesting tomography use.
Area of Science:
- Orthopedic surgery
- Radiology
- Emergency medicine
Background:
- Acute ankle injuries are common.
- Identifying occult fractures is crucial for proper management.
- Radiographic ankle effusions may indicate underlying fractures.
Purpose of the Study:
- Determine the incidence of occult ankle fractures.
- Assess the correlation between radiographic ankle effusions and occult fractures.
Main Methods:
- Prospective study of patients with acute ankle injuries.
- Inclusion criteria: ecchymosis/edema over two+ ligaments, radiographic effusion without fracture.
- Ankle tomography performed for all eligible patients.
Main Results:
- Minimum incidence of occult fractures is 1%.
- 35% of patients with acute, severe injuries had occult fractures.
- Ankle effusion size correlated with occult fracture presence (35-85% of cases).
Conclusions:
- Plain film tomography is recommended for ankle injuries with specific clinical and radiographic findings.
- Consider tomography when edema/ecchymosis over two+ ligaments and radiographic effusion are present simultaneously.