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Advantages of preoperative planning using computed tomography scan for treatment of malleolar ankle fractures

Authors
  • Tarallo, Luigi
  • Micheloni, Gian Mario
  • Mazzi, Michele
  • Rebeccato, Arturo
  • Novi, Michele
  • Catani, Fabio
Type
Published Article
Journal
World Journal of Orthopedics
Publisher
Baishideng Publishing Group Co (World Journal of Orthopedics)
Publication Date
Mar 18, 2021
Volume
12
Issue
3
Pages
129–139
Identifiers
DOI: 10.5312/wjo.v12.i3.129
PMID: 33816140
PMCID: PMC7995337
Source
PubMed Central
Keywords
Disciplines
  • Minireviews
License
Green

Abstract

Malleolar ankle fractures have been classified using plain radiographs, and there is no consensus regarding the role of computed tomography (CT) scans in preoperative planning. We analyzed critical aspects, such as limits of standard radiographs, types of injury, classification methods and cost/benefit evaluations. CT scans allow a 3D analysis of the fracture to be obtained and consequently assess the indication for surgical procedure, surgical access and the type of fixation devices required. This exam is useful for detecting lesions that may go unnoticed on radiographs and will help surgeons to clarify the pathoanatomy of ankle fractures. According to Arbeitsgemeinschaft fur Osteosynthesefragen/ Orthopaedic Trauma Association (AO/OTA) classification, CT scan is recommended in medial malleolar fractures with vertical rim, type 44B fractures with posterior malleolar involvement and all type 44C fractures (according to AO/OTA). Also Tillaux-Chaput fractures (43-B1 according to AO/OTA), malleolar fractures in the presence of distal tibial fractures (43 according to AO/OTA) and distal tibia fractures in adolescents should be studied with CT scans.

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