The Influence of Sagittal Angle of Posterior Malleolus Fracture on Ankle Joint Stability: A Retrospective Study of 120 Cases

Objective Due to the different force exerted during the posterior malleolus fracture (PMF), the difference in sagittal angle (SA) between the fracture fragments may affect ankle stability. But this aspect is less well studied and the aim of this study was to investigate the relationship between SA a...

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Main Authors: Lei Zhang, Yuening Yang, Xiaoyao Peng, Jixiang Xiong, Xinghao Sun, Zhangrong Xia, Bin Xiong, Guoyou Wang
Format: Article
Language:English
Published: Wiley 2023-07-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.13771
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author Lei Zhang
Yuening Yang
Xiaoyao Peng
Jixiang Xiong
Xinghao Sun
Zhangrong Xia
Bin Xiong
Guoyou Wang
author_facet Lei Zhang
Yuening Yang
Xiaoyao Peng
Jixiang Xiong
Xinghao Sun
Zhangrong Xia
Bin Xiong
Guoyou Wang
author_sort Lei Zhang
collection DOAJ
description Objective Due to the different force exerted during the posterior malleolus fracture (PMF), the difference in sagittal angle (SA) between the fracture fragments may affect ankle stability. But this aspect is less well studied and the aim of this study was to investigate the relationship between SA and the stability of PMF. Methods The imaging data of 120 patients with PMFs from January 2014 to November 2022 were collected retrospectively and reconstructed. We first measured SA, posterior fragment area (PFA) and fragment area ratio (FAR), reanalyzing the correlation of SA with PFA and FAR, respectively. To better describe the morphological characteristics of the fracture fragments, we further measured the fragment width diameter ratio (FWR), the fragment length ratio (FLR), fragment height (FH), contact area (CA), and finally carried these data into the regression model of SA versus FAR to conduct the intermediary role. Results SA was negatively correlated with PFA(s) (r = −0.583, P < 0.001), with regression equation s = −0.063SA + 3.066; SA was negatively correlated with FAR (r = −0.204, P < 0.05), with regression equation FAR = −0.002SA + 0.198; A significant correlation was found between FWR, FLR, FH, CA and SA (P < 0.05), as well as between FWR, FLR, FH and FAR (P < 0.05); Further intermediary role analysis showed that FWR, FLR, FH had a partial intermediary role between SA and FAR. Conclusions As SA increased, PFA and FAR decreased, so the larger the SA was due to the effect of vertical shear force, reflecting higher ankle stability, meanwhile, FWR, FLR and FH should also be considered on the fixation method of fracture fragments.
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spelling doaj.art-bff24ad8e3514d15b18438c479f96f232023-07-17T01:41:02ZengWileyOrthopaedic Surgery1757-78531757-78612023-07-011571799180510.1111/os.13771The Influence of Sagittal Angle of Posterior Malleolus Fracture on Ankle Joint Stability: A Retrospective Study of 120 CasesLei Zhang0Yuening Yang1Xiaoyao Peng2Jixiang Xiong3Xinghao Sun4Zhangrong Xia5Bin Xiong6Guoyou Wang7Department of Orthopedics The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University Luzhou ChinaSchool of Clinical Medicine Southwest Medical University Luzhou ChinaSchool of Clinical Medicine Southwest Medical University Luzhou ChinaSchool of Clinical Medicine Southwest Medical University Luzhou ChinaSchool of Clinical Medicine Southwest Medical University Luzhou ChinaSchool of Clinical Medicine Southwest Medical University Luzhou ChinaSchool of Clinical Medicine Southwest Medical University Luzhou ChinaDepartment of Orthopedics The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University Luzhou ChinaObjective Due to the different force exerted during the posterior malleolus fracture (PMF), the difference in sagittal angle (SA) between the fracture fragments may affect ankle stability. But this aspect is less well studied and the aim of this study was to investigate the relationship between SA and the stability of PMF. Methods The imaging data of 120 patients with PMFs from January 2014 to November 2022 were collected retrospectively and reconstructed. We first measured SA, posterior fragment area (PFA) and fragment area ratio (FAR), reanalyzing the correlation of SA with PFA and FAR, respectively. To better describe the morphological characteristics of the fracture fragments, we further measured the fragment width diameter ratio (FWR), the fragment length ratio (FLR), fragment height (FH), contact area (CA), and finally carried these data into the regression model of SA versus FAR to conduct the intermediary role. Results SA was negatively correlated with PFA(s) (r = −0.583, P < 0.001), with regression equation s = −0.063SA + 3.066; SA was negatively correlated with FAR (r = −0.204, P < 0.05), with regression equation FAR = −0.002SA + 0.198; A significant correlation was found between FWR, FLR, FH, CA and SA (P < 0.05), as well as between FWR, FLR, FH and FAR (P < 0.05); Further intermediary role analysis showed that FWR, FLR, FH had a partial intermediary role between SA and FAR. Conclusions As SA increased, PFA and FAR decreased, so the larger the SA was due to the effect of vertical shear force, reflecting higher ankle stability, meanwhile, FWR, FLR and FH should also be considered on the fixation method of fracture fragments.https://doi.org/10.1111/os.13771Ankle joint stabilityPosterior fragmentPosterior malleolus fractureSagittal angle
spellingShingle Lei Zhang
Yuening Yang
Xiaoyao Peng
Jixiang Xiong
Xinghao Sun
Zhangrong Xia
Bin Xiong
Guoyou Wang
The Influence of Sagittal Angle of Posterior Malleolus Fracture on Ankle Joint Stability: A Retrospective Study of 120 Cases
Orthopaedic Surgery
Ankle joint stability
Posterior fragment
Posterior malleolus fracture
Sagittal angle
title The Influence of Sagittal Angle of Posterior Malleolus Fracture on Ankle Joint Stability: A Retrospective Study of 120 Cases
title_full The Influence of Sagittal Angle of Posterior Malleolus Fracture on Ankle Joint Stability: A Retrospective Study of 120 Cases
title_fullStr The Influence of Sagittal Angle of Posterior Malleolus Fracture on Ankle Joint Stability: A Retrospective Study of 120 Cases
title_full_unstemmed The Influence of Sagittal Angle of Posterior Malleolus Fracture on Ankle Joint Stability: A Retrospective Study of 120 Cases
title_short The Influence of Sagittal Angle of Posterior Malleolus Fracture on Ankle Joint Stability: A Retrospective Study of 120 Cases
title_sort influence of sagittal angle of posterior malleolus fracture on ankle joint stability a retrospective study of 120 cases
topic Ankle joint stability
Posterior fragment
Posterior malleolus fracture
Sagittal angle
url https://doi.org/10.1111/os.13771
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