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Table 1 Comparison of the characteristics among the groups of the new fracture line classification

From: A novel classification for medial malleolar fracture based on the 3-D reconstruction CT

Characteristics Type 1 (N = 33, 12.1%) Type 2 (N = 112, 41.0%) Type 3 (N = 82, 30.0%) Type 4 (N = 46, 16.8%) Total (N = 273) Significance (P)
Gender Female 14 (42.4%) 58 (51.8%) 44 (53.7%) 24 (52.2%) 140 (51.3%) 0.742
Male 19 (57.6%) 54 (48.2%) 38 (46.3%) 22 (47.8%) 133 (48.7%)
Age (years) 44.4 ± 17.9 45.1 ± 16.4 49.0 ± 14.2 46.1 ± 14.8 46.4 ± 15.7 0.325
Mechanism of injury Low energy 28 (84.8%) 92 (82.1%) 59 (72.0%) 37 (80.4%) 216 (79.1%) 0.275
High energy 5 (15.2%) 20 (17.9%) 23 (28.0%) 9 (19.6%) 57 (20.9%)
Lauge-Hansen classification SE 30 (90.9%) 90 (80.4%) 52 (63.4%) 34 (73.9%) 206 (75.5%) 0.002*
SA 0 (0%) 0 (0%) 6 (7.3%) 0 (0%) 6 (2.2%)
PE 3 (9.1%) 22 (19.6%) 22 (26.8%) 12 (26.1%) 59 (21.6%)
PA 0 (0%) 0 (0%) 2 (2.4%) 0 (0%) 2 (0.7%)
Danis-Weber classification A 0 (0%) 2 (1.8%) 7 (8.5%) 1 (2.2%) 10 (3.7%) 0.012*
B 29 (87.9%) 87 (77.7%) 50 (61.0%) 30 (65.2%) 196 (71.8%)
C 4 (12.1%) 23 (20.5%) 25 (30.5%) 15 (32.6%) 67 (24.5%)
Modified Pankovich classification B 32 (97.0%) 1 (0.9%) 0 (0%) 0 (0%) 33 (12.1%) <0.001*
C 1 (3.0%) 1 (0.9%) 0 (0%) 16 (34.8%) 18 (6.6%)
D 0 (0%) 110 (98.2%) 82 (100%) 30 (65.2%) 222 (81.3%)
Herscovici classification B 28 (38.9%) 39 (34.8%) 2 (1.1%) 3 (6.5%) 72 (26.4%) <0.001*
C 5 (15.2%) 73 (65.2%) 60 (73.2%) 14 (30.4%) 152 (55.7%)
D 0 (0%) 0 (0%) 20 (24.4%) 29 (63.0%) 49 (17.9%)
Anterior and posterior colliculus separation No 3 (9.1%) 108 (96.4%) 77 (93.9%) 16 (34.8%) 204 (74.7%) <0.001*
Yes 30 (90.9%) 4 (3.6%) 5 (6.1%) 30 (65.2%) 69 (25.3%)
Comminuted medial malleolus fracture No 28 (84.8%) 95 (84.8%) 55 (67.1%) 11 (23.9%) 189 (69.2%) <0.001*
Yes 5 (15.2%) 17 (15.2%) 27 (32.9%) 35 (76.1%) 84 (30.8%)
Distal tibiofibular syndesmosis injury No 26 (78.8%) 68 (60.7%) 45 (54.9%) 25 (54.3%) 164 (60.0%) 0.041*
Injury 6 (18.2%) 26 (23.2%) 19 (23.2%) 17 (37.0%) 68 (24.9%)
Separation 1 (3.0%) 18 (16.1%) 18 (21.9%) 4 (8.7%) 41 (15.0%)
Maisonneuve fracture No 32 (97.0%) 107 (95.5%) 80 (97.6%) 45 (97.8%) 264 (96.7%) 0.836
Yes 1 (3.0%) 5 (4.5%) 2 (2.4%) 1 (2.2%) 9 (3.3%)
Lateral displacement of talus (mm) 6.9 ± 4.1 8.6 ± 5.8 9.0 ± 5.8 5.1 ± 3.4 7.9 ± 5.4 <0.001*
Joint surface involvement of distal tibial plafond No 33 (100%) 106 (94.6%) 55 (67.1%) 17 (37.0%) 211 (77.3%) <0.001*
Yes 0 (0%) 6 (5.4%) 27 (32.9%) 29 (63.0%) 62 (22.7%)
Angle between the major fracture line and distal tibial plafond (degree) 6.6 ± 12.1 16.3 ± 13.3 37.2 ± 17.0 55.0 ± 14.8 26.3 ± 21.0 <0.001*
Intraoperative surgical approach Anterior- inferior 33 (100%) 112 (100%) 82 (100%) 35 (76.1%) 262 (96.0%) <0.001*
Posterior-medial 0 (0%) 0 (0%) 0 (0%) 11 (23.9%) 11 (4.0%)
Intraoperative medial malleolus fixation method Lag screw 32 (97.0%) 109 (97.3%) 75 (91.5%) 25 (54.3%) 239 (88.3%) <0.001*
Buttress plate 0 (0%) 0 (0%) 5 (6.1%) 16 (34.8%) 23 (7.7%)
K-wire 1 (3.0%) 3 (2.7%) 2 (2.4%) 5 (10.9%) 11 (4.0%)
Intraoperative tibiofibular syndesmosis repair No 25 (80.6%) 83 (76.9%) 55 (67.9%) 29 (65.9%) 192 (72.7%) 0.274
Yes 6 (19.4%) 25 (23.1%) 26 (32.1%) 15 (34.1%) 72 (27.3%)
Intraoperative posterior malleoli management No surgery 8 (25.8%) 44 (40.7%) 38 (47.0%) 2 (4.5%) 92 (34.9%) <0.001*
Lag screw 14 (45.2%) 35 (32.4%) 26 (32.1%) 9 (20.5%) 84 (31.8%)
Buttress plate 9 (29%) 29 (26.9%) 17 (21.0%) 33 (75.0%) 88 (33.3%)
  1. *Statistically significant P < 0.05. SA supination-adduction, SE supination-external rotation, PA pronation-abduction, PE pronation-external rotation