Prospective Analysis of Medial Clear Space Widening in Weber B Ankle Fractures: A Comparison of Three Methods
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Medial Clear Space (MCS) Widening Under Gravity Assisted Stress
研究概览
简要总结
The investigators purpose of this study is to obtain all three standard of care stress views of the ankle (gravity stress, manual stress, weightbearing stress) to compare the amount of tibiotalar joint instability predicted by each to determine if there are significant differences measured by the differing stress techniques.
详细描述
Rotational ankle injuries are a commonly encountered injury. Classification of these injuries is most commonly by the Danis-Weber (or Weber) classification and the Lauge-Hansen classification.
Within this classification system exists the isolated Weber B or Lauge-Hansen Supination External Rotation 2/4 (SER 2/4) injury which radiographically involves an isolated spiral fracture of the lateral malleolus at the level of the tibiofibular syndesmosis.
The difference between SER2 (isolated) Weber B injuries and SER4 injuries is disruption of the medial ankle mortise structures, either the medial malleolus (4a) or deltoid ligaments (4b) which then can permit increased talar subluxation with potential to result in tibitotalar joint incongruity.
Standard practice is to proceed with operative fixation of rotationally unstable Weber B or SER4b injuries.
To determine the competence of medial ligamentous structures in isolated fractures of the fibula at the level of the syndesmosis when there is minimal widening of the mortise on non weight bearing films there are three plain x-ray views currently widely used and considered standard of care:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 90 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with a Weber B ankle fracture who are skeletally mature (no open physes) and older than 18 years of age.
排除标准
- •Medial and/or posterior Malleolar fracture
- •Any other lower extremity trauma that limits weight bearing
- •Concomitant arthridities/rheumatologic disease (patients with osteoarthritis may be included)
- •Prior fracture
- •Prior surgery of foot, talus or ankle
- •Open fracture
- •Initial NWB xrays with a medial clear space (MCS) > 7 mm or medial clear space> superior clear space (SCS) by 2mm, signifying an unstable fracture prior to stress
- •Protected populations
结局指标
主要结局
Medial Clear Space (MCS) Widening Under Gravity Assisted Stress
时间窗: Day 1 Clinic Visit
Measured distance, millimeters(mm) of the fractured fibula at the level of the syndesmosis joint in patients undergoing gravity assisted stress
Medial Clear Space (MCS) Widening Under Manual External Rotation Stress
时间窗: Day 1 Clinic Visit
Measured distance, millimeters(mm) of the fractured fibula at the level of the syndesmosis joint in patients undergoing manual external rotation stress
Medial Clear Space (MCS) Widening Under Weight-bearing Stress
时间窗: Day 1 Clinic Visit
Measured distance, millimeters(mm) of the fractured fibula at the level of the syndesmosis joint in patients undergoing weight-bearing stress
次要结局
未报告次要终点
研究者
Lucas Marchand
Principle Investigator
University of Utah