RSS-Feed abonnieren
DOI: 10.1055/s-0039-1681049
Radiologic Evaluation of Lower Leg, Ankle, and Foot Fracture Fixation Hardware
Publikationsverlauf
Publikationsdatum:
29. März 2019 (online)
Abstract
Radiologists should be familiar with basic principles of fracture fixation and the normal imaging appearances of implant constructs and their complications. The surgeon's selection of external fixation, intramedullary nail fixation, open reduction and internal fixation, or some combination depends on patient factors, fracture configuration, injury to the soft tissue envelope, and surgeon experience. Complications including loss of fixation with resultant malalignment, nonunion, infection, and posttraumatic osteoarthritis present additional challenges for the surgeon as well as the radiologist. This article reviews the rationale behind fracture fixation in fractures of the lower leg, ankle, and foot. Examples of postoperative complications are also reviewed.
-
References
- 1 Taljanovic MS, Jones MD, Ruth JT, Benjamin JB, Sheppard JE, Hunter TB. Fracture fixation. Radiographics 2003; 23 (06) 1569-1590
- 2 Schwartz AM, Kadakia RJ, Bariteau JT. Surgical management of geriatric ankle fractures. Tech Foot Ankle Surg 2018; 17 (04) 163-168
- 3 Hunter TB, Taljanovic MS, Wild JR. Radiologic Guide to Orthopedic Devices. New York, NY: Cambridge University Press; 2017
- 4 McNamara IR, Smith TO, Shepherd KL. , et al. Surgical fixation methods for tibial plateau fractures. Cochrane Database Syst Rev 2015; 2015 (09) CD009679
- 5 Metcalfe D, Hickson CJ, McKee L, Griffin XL. External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis. J Orthop Traumatol 2015; 16 (04) 275-285
- 6 Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968–1975. Clin Orthop Relat Res 1979; (138) 94-104
- 7 Markhardt BK, Gross JM, Monu JU. Schatzker classification of tibial plateau fractures: use of CT and MR imaging improves assessment. Radiographics 2009; 29 (02) 585-597
- 8 Oestern HJ, Trentz O, Uranues S. Bone and Joint Injuries: Trauma Surgery III. Berlin, Germany: Springer; 2014
- 9 Younan Y, Wong PK, Jose J. , et al. Radiographic assessment of the postoperative knee. Clin Imaging 2017; 42: 68-82
- 10 Schmidt AH, Finkemeier CG, Tornetta III P. Treatment of closed tibial fractures. Instr Course Lect 2003; 52: 607-622
- 11 Beazley J, Mauffrey C, Seligson D. Treatment of acute tibial shaft fractures with an expandable nailing system: a systematic review of the literature. Injury 2011; 42 (Suppl. 04) S11-S16
- 12 White R, Pace GM. Intramedullary nailing. In: Ruedi TP, Buckley R, Moran CG. , eds. AO Principles of Fracture Management. Stuttgart, Germany: Thieme; 2007
- 13 Hutchinson AJ, Frampton AE, Bhattacharya R. Operative fixation for complex tibial fractures. Ann R Coll Surg Engl 2012; 94 (01) 34-38
- 14 Morshed S. Current options for determining fracture union. Adv Med 2014; 2014: 708574
- 15 Lack WD, Starman JS, Seymour R. , et al. Any cortical bridging predicts healing of tibial shaft fractures. J Bone Joint Surg Am 2014; 96 (13) 1066-1072
- 16 Salih S, Blakey C, Chan D. , et al. The callus fracture sign: a radiological predictor of progression to hypertrophic non-union in diaphyseal tibial fractures. Strateg Trauma Limb Reconstr 2015; 10 (03) 149-153
- 17 Whelan DB, Bhandari M, Stephen D. , et al. Development of the radiographic union score for tibial fractures for the assessment of tibial fracture healing after intramedullary fixation. J Trauma 2010; 68 (03) 629-632
- 18 Tall M. Treatment of aseptic tibial shaft non-union without bone defect. Orthop Traumatol Surg Res 2018; 104 (1S): S63-S69
- 19 Nork SE, Barei DP, Schildhauer TA. , et al. Intramedullary nailing of proximal quarter tibial fractures. J Orthop Trauma 2006; 20 (08) 523-528
- 20 Sheikh A, Schweitzer M. Imaging in pre- and post-operative assessment in joint preserving and replacing surgery. Radiol Clin North Am 2009; 47 (04) 761-775
- 21 Metsemakers WJ, Kuehl R, Moriarty TF. , et al. Infection after fracture fixation: current surgical and microbiological concepts. Injury 2018; 49 (03) 511-522
- 22 Tresley J, Schoenleber SJ, Singer AD, Clifford P. “Ilizarov” external fixation: what the radiologist needs to know. Skeletal Radiol 2015; 44 (02) 179-195
- 23 Assal M, Ray A, Stern R. Strategies for surgical approaches in open reduction internal fixation of pilon fractures. J Orthop Trauma 2015; 29 (02) 69-79
- 24 Fracture and dislocation compendium. Orthopaedic Trauma Association Committee for Coding and Classification. J Orthop Trauma 1996; 32 (S1): S49-S60
- 25 Lavini F, Dall'Oca C, Mezzari S. , et al. Temporary bridging external fixation in distal tibial fracture. Injury 2014; 45 (Suppl. 06) S58-S63
- 26 Eastman JG, Firoozabadi R, Benirschke SK, Barei DP, Dunbar RP. Entrapped posteromedial structures in pilon fractures. J Orthop Trauma 2014; 28 (09) 528-533
- 27 Tresley J, Subhawong TK, Singer AD, Clifford PD. Incidence of tendon entrapment and dislocation with calcaneus and pilon fractures on CT examination. Skeletal Radiol 2016; 45 (07) 977-988
- 28 Crim J, Enslow M, Smith J. CT assessment of the prevalence of retinacular injuries associated with hindfoot fractures. Skeletal Radiol 2013; 42 (04) 487-492
- 29 Ruokun H, Ming X, Zhihong X. , et al. Postoperative radiographic and clinical assessment of the treatment of posterior tibial plafond fractures using a posterior lateral incisional approach. J Foot Ankle Surg 2014; 53 (06) 678-682
- 30 Okanobo H, Khurana B, Sheehan S, Duran-Mendicuti A, Arianjam A, Ledbetter S. Simplified diagnostic algorithm for Lauge-Hansen classification of ankle injuries. Radiographics 2012; 32 (02) E71-E84
- 31 Mandi DM. Ankle fractures. Clin Podiatr Med Surg 2012; 29 (02) 155-186 , vii
- 32 Lo EY, Lee MA. New concepts in the surgical management of ankle fractures. Orthopedics 2008; 31 (09) 868-872
- 33 Irwin TA, Lien J, Kadakia AR. Posterior malleolus fracture. J Am Acad Orthop Surg 2013; 21 (01) 32-40
- 34 Taljanovic MS, Hunter TB, Miller MD, Sheppard JE. Gallery of medical devices: Part 1: Orthopedic devices for the extremities and pelvis. Radiographics 2005; 25 (03) 859-870
- 35 Jordan RW, Chapman AWP, Buchanan D, Makrides P. The role of intramedullary fixation in ankle fractures—a systematic review. Foot Ankle Surg 2018; 24 (01) 1-10
- 36 Lawson KA, Ayala AE, Morin ML, Latt LD, Wild JR. Ankle fracture-dislocations: a review. Foot Ankle Orthop 2018; http://doi.org/10.1177/2473011418765122
- 37 Lindsjö U. Operative treatment of ankle fracture-dislocations. A follow-up study of 306/321 consecutive cases. Clin Orthop Relat Res 1985; (199) 28-38
- 38 Bible JE, Sivasubramaniam PG, Jahangir AA, Evans JM, Mir HR. High-energy transsyndesmotic ankle fracture dislocation—the “logsplitter” injury. J Orthop Trauma 2014; 28 (04) 200-204
- 39 Lynde MJ, Sautter T, Hamilton GA, Schuberth JM. Complications after open reduction and internal fixation of ankle fractures in the elderly. Foot Ankle Surg 2012; 18 (02) 103-107
- 40 SooHoo NF, Krenek L, Eagan MJ, Gurbani B, Ko CY, Zingmond DS. Complication rates following open reduction and internal fixation of ankle fractures. J Bone Joint Surg Am 2009; 91 (05) 1042-1049
- 41 Lindsjö U. Operative treatment of ankle fracture-dislocations. A follow-up study of 306/321 consecutive cases. Clin Orthop Relat Res 1985; (199) 28-38
- 42 Mandi DM, Nickles WA, Mandracchia VJ, Halligan JB, Toney PA. Ankle fractures. Clin Podiatr Med Surg 2006; 23 (02) 375-422 , vii
- 43 Dattani R, Patnaik S, Kantak A, Srikanth B, Selvan TP. Injuries to the tibiofibular syndesmosis. J Bone Joint Surg Br 2008; 90 (04) 405-410
- 44 Petscavage JM, Perez F, Khorashadi L, Richardson ML. Tightrope walking: a new technique in ankle syndesmosis fixation. Radiol Case Rep 2015; 5 (01) 354
- 45 Sproule JA, Khalid M, O'Sullivan M, McCabe JP. Outcome after surgery for Maisonneuve fracture of the fibula. Injury 2004; 35 (08) 791-798
- 46 Stufkens SA, van den Bekerom MP, Doornberg JN, van Dijk CN, Kloen P. Evidence-based treatment of Maisonneuve fractures. J Foot Ankle Surg 2011; 50 (01) 62-67
- 47 Naqvi GA, Shafqat A, Awan N. Tightrope fixation of ankle syndesmosis injuries: clinical outcome, complications and technique modification. Injury 2012; 43 (06) 838-842
- 48 Bernstein J, Ahn J. In brief: Fractures in brief: calcaneal fractures. Clin Orthop Relat Res 2010; 468 (12) 3432-3434
- 49 Kiewiet NJ, Sangeorzan BJ. Calcaneal fracture management: extensile lateral approach versus small incision technique. Foot Ankle Clin 2017; 22 (01) 77-91
- 50 Daftary A, Haims AH, Baumgaertner MR. Fractures of the calcaneus: a review with emphasis on CT. Radiographics 2005; 25 (05) 1215-1226
- 51 Griffin D, Parsons N, Shaw E. , et al; UK Heel Fracture Trial Investigators. Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial. BMJ 2014; 349: g4483
- 52 Mehta CR, An VVG, Phan K, Sivakumar B, Kanawati AJ, Suthersan M. Extensile lateral versus sinus tarsi approach for displaced, intra-articular calcaneal fractures: a meta-analysis. J Orthop Surg Res 2018; 13 (01) 243
- 53 De Boer AS, Van Lieshout EM, Den Hartog D, Weerts B, Verhofstad MH, Schepers T. Functional outcome and patient satisfaction after displaced intra-articular calcaneal fractures: a comparison among open, percutaneous, and nonoperative treatment. J Foot Ankle Surg 2015; 54 (03) 298-305
- 54 Kumar N. Non-union of calcaneum—a rare complication of calcaneal fracture. A case report with brief review of literature. J Clin Orthop Trauma 2015; 6 (03) 187-189
- 55 Stephens HM, Sanders R. Calcaneal malunions: results of a prognostic computed tomography classification system. Foot Ankle Int 1996; 17 (07) 395-401
- 56 Dale JD, Ha AS, Chew FS. Update on talar fracture patterns: a large level I trauma center study. AJR Am J Roentgenol 2013; 201 (05) 1087-1092
- 57 Jordan RK, Bafna KR, Liu J, Ebraheim NA. complications of talar neck fractures by Hawkins classification: a systematic review. J Foot Ankle Surg 2017; 56 (04) 817-821
- 58 Buza III JA, Leucht P. Fractures of the talus: current concepts and new developments. Foot Ankle Surg 2018; 24 (04) 282-290
- 59 Liu H, Chen Z, Zeng W. , et al. Surgical management of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation. J Orthop Surg Res 2017; 12 (01) 111
- 60 Melenevsky Y, Mackey RA, Abrahams RB, Thomson III NB. Talar fractures and dislocations: a radiologist's guide to timely diagnosis and classification. Radiographics 2015; 35 (03) 765-779
- 61 Whitaker C, Turvey B, Illical EM. Current concepts in talar neck fracture management. Curr Rev Musculoskelet Med 2018; 11 (03) 456-474
- 62 Sanders DW, Busam M, Hattwick E, Edwards JR, McAndrew MP, Johnson KD. Functional outcomes following displaced talar neck fractures. J Orthop Trauma 2004; 18 (05) 265-270
- 63 Vallier HA, Nork SE, Benirschke SK, Sangeorzan BJ. Surgical treatment of talar body fractures. J Bone Joint Surg Am 2004; 86-A (Pt 2, Suppl 1): 180-192
- 64 Tezval M, Dumont C, Stürmer KM. Prognostic reliability of the Hawkins sign in fractures of the talus. J Orthop Trauma 2007; 21 (08) 538-543
- 65 Sproule JA, Glazebrook MA, Younger AS. Varus hindfoot deformity after talar fracture. Foot Ankle Clin 2012; 17 (01) 117-125
- 66 Clements JR, Dijour F, Leong W. Surgical management navicular and cuboid fractures. Clin Podiatr Med Surg 2018; 35 (02) 145-159
- 67 Saxena A, Fullem B, Hannaford D. Results of treatment of 22 navicular stress fractures and a new proposed radiographic classification system. J Foot Ankle Surg 2000; 39 (02) 96-103
- 68 Saxena A, Behan SA, Valerio DL, Frosch DL. Navicular stress fracture outcomes in athletes: analysis of 62 injuries. J Foot Ankle Surg 2017; 56 (05) 943-948
- 69 Shakked RJ, Walters EE, O'Malley MJ. Tarsal navicular stress fractures. Curr Rev Musculoskelet Med 2017; 10 (01) 122-130
- 70 Potter NJ, Brukner PD, Makdissi M, Crossley K, Kiss ZS, Bradshaw C. Navicular stress fractures: outcomes of surgical and conservative management. Br J Sports Med 2006; 40 (08) 692-695 ; discussion 695
- 71 Fowler JR, Gaughan JP, Boden BP, Pavlov H, Torg JS. The non-surgical and surgical treatment of tarsal navicular stress fractures. Sports Med 2011; 41 (08) 613-619
- 72 Siddiqui NA, Galizia MS, Almusa E, Omar IM. Evaluation of the tarsometatarsal joint using conventional radiography, CT, and MR imaging. Radiographics 2014; 34 (02) 514-531
- 73 Nunley JA, Vertullo CJ. Classification, investigation, and management of midfoot sprains: Lisfranc injuries in the athlete. Am J Sports Med 2002; 30 (06) 871-878
- 74 DeOrio M, Erickson M, Usuelli FG, Easley M. Lisfranc injuries in sport. Foot Ankle Clin 2009; 14 (02) 169-186
- 75 Stavlas P, Roberts CS, Xypnitos FN, Giannoudis PV. The role of reduction and internal fixation of Lisfranc fracture-dislocations: a systematic review of the literature. Int Orthop 2010; 34 (08) 1083-1091
- 76 Alberta FG, Aronow MS, Barrero M, Diaz-Doran V, Sullivan RJ, Adams DJ. Ligamentous Lisfranc joint injuries: a biomechanical comparison of dorsal plate and transarticular screw fixation. Foot Ankle Int 2005; 26 (06) 462-473
- 77 Sarpong NO, Swindell HW, Trupia EP. , et al. Metatarsal fractures. Foot Ankle Orthop 2018; http://doi.org/10.1177/2473011418775094
- 78 Bowes J, Buckley R. Fifth metatarsal fractures and current treatment. World J Orthop 2016; 7 (12) 793-800
- 79 Thompson P, Patel V, Fallat LM, Jarski R. Surgical management of fifth metatarsal diaphyseal fractures: a retrospective outcomes study. J Foot Ankle Surg 2017; 56 (03) 463-467
- 80 Bica D, Sprouse RA, Armen J. Diagnosis and management of common foot fractures. Am Fam Physician 2016; 93 (03) 183-191
- 81 Armagan OE, Shereff MJ. Injuries to the toes and metatarsals. Orthop Clin North Am 2001; 32 (01) 1-10