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%) | ||