Learning objectives
Readers of this exhibit will be:
Given a detailed overview of the osteoligamentous anatomy of the ankle
Introduced to the Weber and Lauge-Hansen classification,
using multimodality imaging (X-ray,
CT with 3D-reconstructions and MR)
Able to classify ankle injuries into stable and unstable trauma,
using several radiographic signs and fracture patterns
Able to suspect different ligamentous ankle lesions on X-ray images
Background
FREQUENCY OF ANKLE INJURIES
Ankle injuries are one of the most common articular injuries in the body with an estimated incidence rate of 2.15 per 1000 person-years.
The peak incidence of ankle injuries occurre between fifteen and nineteen years of age (7.2 per 1000 person-years).
Supination injuries predominate,
causing more trauma at the lateral side.
85% of the injuries are "sprains",
while 15% is more complex.
Nearly half of all ankle sprains occur during athletic activity,
such as soccer.
I.
OSTEOARTICULAR ANATOMY OF THE ANKLE...
Findings and procedure details
In this section we will show several cases from our institution,
and where possible applying the Lauge-Hansen classification system in order to classify the injuries.
Using this system,
we can inform our clinician or orthopaedic surgeon on the possible lesions (bony and ligamentous) of the ankle.
CASE 1:
A 71 year old female patient presents at the emergency department with a "twisted" left ankle.
She missed a step walking on the street.
X-ray imaging was performed.
The AP and Mortise view of the left ankle...
Conclusion
Ankle injuries are very common entities in the radiologic department.
Several mechanisms of trauma lead to very different fracture patterns.
The 3D-CT images and the flowcharts provided in this exhibit may aid in understanding the complex classification system by Lauge-Hansen.
Not every type of fracture can be explained by this system,
but it gives a great insight in understanding the mechanism of ankle injuries and may even be a guide in unraveling the very complex fractures.
Personal information
Yannick De Brucker,
MD
4th year Resident at the Institute of Diagnostic Radiology
Vrije Universiteit Brussel / UZ Brussel
Laarbeeklaan 101 - 1090 Brussels
BELGIUM
@ :
[email protected]
www.uzbrussel.be
___________________________________
Tjeerd Jager,
MD
Department of Radiology ASZ Aalst
Merestraat 80,
9300 Aalst
BELGIUM
@ :
[email protected]
www.asz.be
___________________________________
Hannes Devos,
MD
4th year Resident at the Institute of Diagnostic Radiology
Vrije Universiteit Brussel / UZ Brussel
Laarbeeklaan 101 - 1090 Brussels
BELGIUM
@ :
[email protected]
www.uzbrussel.be
___________________________________
Johan de Mey,
MD,
PhD
Head of Department...
References
1.
Neuschwander TB,
Indresano AA,
Hughes TH,
Smith BW.
Footprint of the lateral ligament complex of the ankle.
Foot Ankle Int.
2013 Apr;34(4):582-6.
2.
Golanó P,
Vega J,
de Leeuw PA,
Malagelada F,
Manzanares MC,
Götzens V,
van Dijk CN.
Anatomy of the ankle ligaments: a pictorial essay.
Knee Surg Sports Traumatol Arthrosc.
2010 May;18(5):557-69.
3.
Hermans JJ,
Beumer A,
de Jong TA,
Kleinrensink GJ.
Anatomy of the distal tibiofibular syndesmosis in adults: a pictorial essay with a multimodality approach.
J Anat.
2010 Dec;217(6):633-45.
4....