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False negative rate of syndesmotic injury in pronation-external rotation stage IV ankle fractures

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Author(s)
Kwang‑Soon SongSin‑Gi KimYoung‑Jae LimJong‑Hyuk JeonKyunng‑Keun Min
Keimyung Author(s)
Song, Kwang Soon
Department
Dept. of Orthopedic Surgery (정형외과학)
Journal Title
Indian Journal of Orthopaedics
Issued Date
2013
Volume
47
Issue
5
Abstract
Background: To investigate false negative rate in the diagnosis of diastasis on initial static anteroposterior radiograph and reliability
of intraoperative external rotational stress test for detection of concealed disruption of syndesmosis in pronation external rotation
(PER) stage IV (Lauge‑Hansen) ankle fractures.
Materials and Methods: We prospectively studied 34 PER stage IV ankle fractures between September 2001 and September
2008. Twenty (59%) patients show syndesmotic injury on initial anteroposterior radiographs. We performed an intraoperative
external rotation stress test in other 14 patients with suspicious PER stage IV ankle fractures, which showed no defined syndesmotic
injury on anteroposterior radiographs inspite of a medial malleolar fracture, an oblique fibular fracture above the syndesmosis
and fracture of the posterior tubercle of the tibia.
Results: All 14 fractures showed different degrees of tibiofibular clear space (TFCS) and tibiofibular overlapping (TFO) on the
external rotation stress test radiograph compared to the initial plain anteroposterior radiograph. It is important to understand the
fracture pattern characterstic of PER stage IV ankle fractures even though it appears normal on anteroposterior radiographs, it
is to be confirmed for the concealed syndesmotic injury through a routine intraoperative external rotational stress radiograph.
Key words: Ankle fracture, external rotation stress test, false negative, syndesmotic injury
Keimyung Author(s)(Kor)
송광순
Publisher
School of Medicine
Citation
Kwang‑Soon Song et al. (2013). False negative rate of syndesmotic injury in pronation-external
rotation stage IV ankle fractures. Indian Journal of Orthopaedics, 47(5), 482–486. doi: 10.4103/0019-5413.118204
Type
Article
ISSN
0019-5413
DOI
10.4103/0019-5413.118204
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35860
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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