Ankle Fracture with a Complex Injury Mechanism and Misleading Hook Test Result: A Case Report.

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Abstract

[Indexed for MEDLINE] 17. Ulus Travma Acil Cerrahi Derg. 2024 Oct;30(10):754-760. doi: 10.14744/tjtes.2024.37225. Trans-syndesmotic fixation in supination external rotation type 4 injuries: Are intraoperative tests reliable? Çalışkan G(1), Elmas Y(1), Çelik O(1). Author information: (1)University of Health Sciences Istanbul Kanuni Sultan Suleyman Training and Research Hospital, İstanbul-Türkiye. BACKGROUND: Ankle fractures occur due to a rotational mechanism. According to the Lauge-Hansen classification, supination-external rotation (SER) injuries are the most common type. Following osseous fixation, the evaluation and treatment of syndesmotic injuries in these injuries are controversial. This study aimed to evaluate the clinical, functional, and radiological results of trans-syndesmotic fixation using intraoperative tests in SER type 4 ankle injuries. METHODS: Ankle syndesmosis was intraoperatively evaluated using cotton/hook and manual external rotation stress tests in 64 patients with SER type 4 fracture dislocation injuries. These patients were divided into two groups: those treated with and without trans-syndesmotic fixation in addition to open reduction and internal fixation of the fractures. Ankle range of motion (ROM), American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, and Olerud-Molander Ankle Score (OMAS), tibiofibular overlap, tibiofibular clear space, and joint arthritis based on the Kellgren-Lawrence (K-L) scale were evaluated. RESULTS: Median values of OMAS (Z=-3.92, p