Reliability of early postoperative x-rays in ankle fractures

BackhroundsEvaluating the accuracy of reduction of ankle fractures using postoperative x-rays remainedcontroversial. Some authors demonstrated the advantages of postoperative CT scanningin these injuries. In current study, we investigated the efficacy of postoperative x-rayscompared to CT scanning to evaluate the reduction accuracy and stability.MethodsThere were 44 patients with ankle fractures underwent open reduction internal fixation(ORIF). After the operation, if the reduction was appropriate and stable on x-rays, CTscanning was performed to evaluate the accuracy of fracture reduction. Abnormal CTfindings included malreduction, device malpositioning, missed fracture, intraarticularfragment.ResultsAbnormal CT findings were present in 25 patients (%56.8). In 19 patients, CT confirmed the appropriate and stable reduction without device malpositioning. The most common CTfindings were malreduction in 23 patients and device malpositioning in 18 patients. Therewas no abnormal CT finding in lateral malleolar fractures while two third of syndesmosisinjuries were inappropriate on CT images.ConclusionsBased on the considerable percentage of patients with abnormal CT findings (malreduction,device malpositioning, missed fracture, intraarticular fragment) after ankle ORIF, it isnecessary to evaluate the accuracy of ankle fracture reduction on postoperative CT images.