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The tibiofibular overlap is less than 3 mm
11%
212/1903
The fibula demonstrates a Weber C fracture pattern
6%
111/1903
The tibiofibular clear space is less than 4 mm
66%
1257/1903
The fracture is consistent with a Lauge-Hansen pronation-external rotation injury pattern
14%
259/1903
The medial clear space is greater than 5 mm
3%
55/1903
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The AP radiograph demonstrates a stable, minimally displaced Weber B ankle fracture. It is consistent with a Lauge-Hansen supination-external rotation injury pattern. Harper et al performed cadaveric measurements to define normal radiographic values for standard ankle imaging. The tibiofibular overlap is defined as the horizontal distance from the lateral border of the posterior tibial malleolus (the incisura fibularis) and the medial border of the fibula at the point where the posterior malleolus is widest on an AP radiograph should be great than 6 mm. Tibiofibular clear space is defined as the horizontal distance between the medial border of the fibula and the lateral border of the anterior tibial prominence on an AP radiograph, and should be <6mm. The medial clear space, defined as the distance between the lateral aspect of the medial malleolus and the medial border of the talus at the level of the talar dome on the mortise radiograph should be less than 4 mm. Ostrum et al performed a radiographic study on human volunteers and noted gender differences. In this study, normal tibial clear space should be less than 5.2 mm in women and less than 6.5 mm in men. The tibiofibular overlap should be greater than 2.7 mm in women and greater than 5.7 mm in men. Illustration A is an example of the proper measurement of the tib-fib clear space.
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