The incisura tibialis is formed by the anterior (Chaput’s tubercle) (1) and posterior tubercle (2) of the tibia. The concave-shaped incisura tibialis (filled arrowhead) matches the convex shape of the fibula. (C) Axial computerized tomography (CT) image at the level of the distal tibiofibular. The tibia is concave-shaped in the sagittal plane and the arc length of the talus with around 120° is greater in comparison to the tibia with its 80°. (B) Lateral radiograph of the ankle of the same patient of (A). Regarding the length of the fibula, the articular portion reaches further in distal direction in comparison to the medial malleolus. (A) Ankle anteroposterior (AP) mortise view of a healthy young male showing the configuration between distal tibia, distal fibula and talus. The contact zone between tibia and fibula is covered by a thin layer of cartilage forming the syndesmotic recess. Likewise, the anterior (Le Fort-Wagstaffe tubercle) and posterior tubercle of the fibula form a convex triangle. The incisura tibialis is formed by the anterior (Chaput’s tubercle) and posterior tubercle of the tibia ( Fig. The concave-shaped incisura tibialis matches the convex shape of the fibula ( Fig. 4– 6 Besides the connection between tibia and talus, there exists a close interaction between tibia and fibula. Considering the bone mineral density of the tibia, the articular site shows a higher density in comparison to the metaphysis. Looking at the coronal plane, the tibia shows a slight slope from medial to lateral and is concave-shaped in the sagittal plane ( Fig. 2, 3įrom the tibia, the facies articularis medialis (pilon) and the facies articularis inferior are connected to the talus. Tibia, fibula and talus are interconnected through collateral ligaments and the syndesmotic ligament complex. 1 The talocrural (TC) joint is formed by three bones and a complex ligamentous apparatus. The human ankle joint complex can be divided in a talocrural, a talocalcaneonavicular and a subtalar part. This review considers current scientific findings regarding all three malleoli to understand the complexity of trimalleolar ankle injuries and provide the reader with an overview of treatment strategies and research, as well as future perspectives.Ĭite this article: EFORT Open Rev 2021 6:692-703. In younger, more demanding patients, arthroscopic-assisted surgery might improve the outcome, but future research is required to identify patients who will benefit from assisted surgical care. In patients with osteoporotic trimalleolar ankle fractures and relevant concomitant conditions, further evidence is awaited to specify indications for open reduction and internal fixation or primary transfixation of the ankle joint. With a growing number of elderly patients, trimalleolar ankle injuries will become more relevant in the form of fragility fractures, posing a particular challenge for trauma surgeons. Trimalleolar ankle fractures have a rising incidence in the last decade with up to 40 per 100,000 people per year. Computed tomography is important for the operative planning by providing an elaborated view of the posterior malleolus. A trimalleolar ankle fracture is considered unstable and treatment is generally performed operatively.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |