Abstract：
BACKGROUND: Alteration of sagittal alignment during fracture fixation directly impacts ankle motion in dorsiflexion and plantarflexion. Previously research measured the anterior distal tibia angle (ADTA) in a normal healthy population. The null hypothesis for this study is that ADTA is restored to normal range following unstable pilon fractures. The aim of this study is to identify the range of the ADTA in distal tibia fractures after surgical fixation, compared to a previously published normal population.
METHODS: A retrospective review of operative distal tibia fractures (AO/OTA classification 43A and 43C - 43B were excluded due to lower likelihood of fracture changing the ADTA) was performed. ADTA on lateral radiograph was measured as the angle relative to the tibia shaft.
RESULTS: 100 patients with post-operative radiographs that met inclusion criteria were analyzed. The average ADTA was 6.9° (⌠=4.62°) with a maximum slope of 19.2° (i.e. anterior orientation) and a minimum of -3.3° (i.e. posterior orientation). The uninjured population had an average ADTA of 6.0° (range -2.0°-14°, ⌠=3.0°).
CONCLUSIONS: This analysis shows the average distal tibia sagittal alignment in the post-surgical group is similar to a normal, uninjured population. Large alterations in ADTA would directly impact the ankle in the plane of motion (i.e. negative ADTA would decrease ankle dorsiflexion). Considering ADTA as an objective intra-operative parameter optimizes sagittal plane alignment.
METHODS: A retrospective review of operative distal tibia fractures (AO/OTA classification 43A and 43C - 43B were excluded due to lower likelihood of fracture changing the ADTA) was performed. ADTA on lateral radiograph was measured as the angle relative to the tibia shaft.
RESULTS: 100 patients with post-operative radiographs that met inclusion criteria were analyzed. The average ADTA was 6.9° (⌠=4.62°) with a maximum slope of 19.2° (i.e. anterior orientation) and a minimum of -3.3° (i.e. posterior orientation). The uninjured population had an average ADTA of 6.0° (range -2.0°-14°, ⌠=3.0°).
CONCLUSIONS: This analysis shows the average distal tibia sagittal alignment in the post-surgical group is similar to a normal, uninjured population. Large alterations in ADTA would directly impact the ankle in the plane of motion (i.e. negative ADTA would decrease ankle dorsiflexion). Considering ADTA as an objective intra-operative parameter optimizes sagittal plane alignment.
摘要：
背景：骨折固定过程中矢状排列的改变直接影响踝关节背屈和前屈运动。先前的研究测量了正常健康人群的胫骨远端前角（ADTA）。这项研究的零假设是ADTA在不稳定的Pilon骨折后恢复到正常范围。这项研究的目的是确定手术固定后胫骨远端骨折的ADTA范围。与以前发表的正常人群相比。
方法：对胫骨远端手术骨折（AO/OTA分类43A和43C-43B被排除，因为骨折改变ADTA的可能性较低）进行回顾性回顾。横向X光片上的ADTA测量为相对于胫骨轴的角度。
结果：分析了100例符合纳入标准的术后X线片患者。平均ADTA为6.9°(=4.62°),最大斜率为19.2°(即前向),最小值为-3.3°(即后向)。未受伤人群的平均ADTA为6.0°（范围-2.0°-14°，=3.0°)。
结论：该分析显示，术后组胫骨远端矢状位的平均排列与正常，未受伤的人口。ADTA的较大改变将直接影响运动平面中的踝关节(即,负ADTA将减少踝关节背屈)。将ADTA视为客观的术中参数可优化矢状平面对齐。
方法：对胫骨远端手术骨折（AO/OTA分类43A和43C-43B被排除，因为骨折改变ADTA的可能性较低）进行回顾性回顾。横向X光片上的ADTA测量为相对于胫骨轴的角度。
结果：分析了100例符合纳入标准的术后X线片患者。平均ADTA为6.9°(=4.62°),最大斜率为19.2°(即前向),最小值为-3.3°(即后向)。未受伤人群的平均ADTA为6.0°（范围-2.0°-14°，
结论：该分析显示，术后组胫骨远端矢状位的平均排列与正常，未受伤的人口。ADTA的较大改变将直接影响运动平面中的踝关节(即,负ADTA将减少踝关节背屈)。将ADTA视为客观的术中参数可优化矢状平面对齐。
