Retrospective/prospective cohort study of 62 patients with distal third tibial fractures, asking: how often is there an occult posterior malleolus fracture, and does a systematic CT protocol improve detection compared to plain radiographs alone?
When you see a spiral distal tibial fracture with a proximal fibula fracture, order a fine-cut ankle CT — 56% of spiral patterns have a concomitant posterior malleolus fracture, and nearly a quarter of those will be invisible on plain films.
Missing it risks intraoperative displacement during IMN reaming and a postoperative course optimized for the wrong injury.
Retrospective/prospective cohort study of 62 patients with distal third tibial fractures, asking: how often is there an occult posterior malleolus fracture, and does a systematic CT protocol improve detection compared to plain radiographs alone?
When you see a spiral distal tibial fracture with a proximal fibula fracture, order a fine-cut ankle CT — 56% of spiral patterns have a concomitant posterior malleolus fracture, and nearly a quarter of those will be invisible on plain films.
Missing it risks intraoperative displacement during IMN reaming and a postoperative course optimized for the wrong injury.