Abstract：
BACKGROUND: Many approaches to management of medial malleolar fractures are described in the literature however, their morphology is under investigated. The aim of this study was to analyse the morphology of medial malleolar fractures to identify any association with medial malleolar fracture non-union or malunion.
METHODS: Patients who had undergone surgical fixation of their MMF were identified from 2012 to 2022, using electronic patient records. Retrospective analysis of their preoperative, intraoperative, and postoperative radiographs was performed to determine their morphology and prevalence of non-union and malunion. Lauge-Hansen classification was used to characterise ankle fracture morphology and Herscovici classification to characterise MMF morphology.
RESULTS: A total of 650 patients were identified across a 10-year period which could be included in the study. The overall non-union rate for our cohort was 18.77% (122/650). The overall malunion rate was 6.92% (45/650). Herscovici type A fractures were significantly more frequently mal-reduced at time of surgery as compared to other fracture types (p = .003). Medial wall blowout combined with Hercovici type B fractures showed a significant increase in malunion rate. There is a higher rate of bone union in patients who had been anatomically reduced.
CONCLUSIONS: The morphology of medial malleolar fractures does have an impact of the radiological outcome following surgical management. Medial wall blowout fractures were most prevalent in adduction-type injuries; however, it should not be ruled out in rotational injuries with medial wall blowouts combined with and Herscovici type B fractures showing a significant increase in malunions. Herscovici type A fractures had significantly higher malreductions.
METHODS: Level 3 - Retrospective Cohort Study.
METHODS: Patients who had undergone surgical fixation of their MMF were identified from 2012 to 2022, using electronic patient records. Retrospective analysis of their preoperative, intraoperative, and postoperative radiographs was performed to determine their morphology and prevalence of non-union and malunion. Lauge-Hansen classification was used to characterise ankle fracture morphology and Herscovici classification to characterise MMF morphology.
RESULTS: A total of 650 patients were identified across a 10-year period which could be included in the study. The overall non-union rate for our cohort was 18.77% (122/650). The overall malunion rate was 6.92% (45/650). Herscovici type A fractures were significantly more frequently mal-reduced at time of surgery as compared to other fracture types (p = .003). Medial wall blowout combined with Hercovici type B fractures showed a significant increase in malunion rate. There is a higher rate of bone union in patients who had been anatomically reduced.
CONCLUSIONS: The morphology of medial malleolar fractures does have an impact of the radiological outcome following surgical management. Medial wall blowout fractures were most prevalent in adduction-type injuries; however, it should not be ruled out in rotational injuries with medial wall blowouts combined with and Herscovici type B fractures showing a significant increase in malunions. Herscovici type A fractures had significantly higher malreductions.
METHODS: Level 3 - Retrospective Cohort Study.
摘要：
背景：文献中描述了许多治疗内踝骨折的方法，他们的形态正在调查中。这项研究的目的是分析内踝骨折的形态，以确定与内踝骨折不愈合或畸形愈合的任何关联。
方法：从2012年到2022年，使用电子病历确定了接受MMF手术固定的患者。术前回顾性分析,术中,并进行术后X线片检查以确定其形态和不愈合和畸形愈合的发生率。Lauge-Hansen分类用于表征踝关节骨折的形态，Herscovici分类用于表征MMF的形态。
结果：在10年的时间里，共确认了650名患者，可纳入本研究。我们队列的整体不愈合率为18.77%(122/650)。整体畸形发生率为6.92%(45/650)。与其他骨折类型相比，HerscoviciA型骨折在手术时明显更频繁地减少（p=.003）。中壁爆裂合并HercoviciB型骨折显示畸形愈合率显着增加。在解剖学上减少的患者中，骨愈合率较高。
结论：内踝骨折的形态对手术治疗后的放射学结果有影响。内壁爆裂性骨折在内收型损伤中最为普遍；然而，不应排除在旋转损伤伴内壁爆裂和HerscoviciB型骨折的情况下，显示不愈合明显增加。HerscoviciA型骨折的复位不良明显较高。
方法：第3级-回顾性队列研究。
方法：从2012年到2022年，使用电子病历确定了接受MMF手术固定的患者。术前回顾性分析,术中,并进行术后X线片检查以确定其形态和不愈合和畸形愈合的发生率。Lauge-Hansen分类用于表征踝关节骨折的形态，Herscovici分类用于表征MMF的形态。
结果：在10年的时间里，共确认了650名患者，可纳入本研究。我们队列的整体不愈合率为18.77%(122/650)。整体畸形发生率为6.92%(45/650)。与其他骨折类型相比，HerscoviciA型骨折在手术时明显更频繁地减少（p=.003）。中壁爆裂合并HercoviciB型骨折显示畸形愈合率显着增加。在解剖学上减少的患者中，骨愈合率较高。
结论：内踝骨折的形态对手术治疗后的放射学结果有影响。内壁爆裂性骨折在内收型损伤中最为普遍；然而，不应排除在旋转损伤伴内壁爆裂和HerscoviciB型骨折的情况下，显示不愈合明显增加。HerscoviciA型骨折的复位不良明显较高。
方法：第3级-回顾性队列研究。
