Rank Order Analysis of Tibial Plafond Fractures: Does Injury or Reduction Predict Outcome?

• Published in: Foot & ankle international 1999-01, Vol.20 (1), p.44-49
• Main Authors: DeCoster, T.A., Willis, M.C., Marsh, J.L, Williams, T.M., Nepola, J.V., Dirschl, D.R., Hurwitz, S.R.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Ankle Injuries - classification; Ankle Injuries - diagnostic imaging; Ankle Injuries - surgery; Ankle Joint - diagnostic imaging; Forecasting; Fracture Fixation - classification; Fracture Fixation - standards; Humans; Joint Diseases - classification; Joint Diseases - diagnostic imaging; Joint Diseases - etiology; Middle Aged; Radiography; Reproducibility of Results; Statistics as Topic - methods; Statistics as Topic - standards; Tibial Fractures - classification; Tibial Fractures - complications; Tibial Fractures - surgery; Trauma Severity Indices; Treatment Outcome
• ISSN: 1071-1007; 1944-7876
• DOI: 10.1177/107110079902000110

We investigated the effects of severity of initial injury pattern and the quality of the articular reduction on outcome of displaced intra-articular distal tibial fractures, using a series of 25 patients who were treated with articulated external fixation and limited internal fixation, which provided a spectrum of reduction quality. Outcome was assessed by clinical ankle scores and radio-graphic arthrosis. The results demonstrate the rank order method to be a reliable means of stratifying severity of injury and quality of reduction. Neither injury nor reduction correlated with clinical ankle score. Reduction had a significant correlation with radiographic arthrosis. We conclude that the rank order method is useful in stratification of fracture patients, and that factors other than injury pattern and quality of articular reduction are important in determining outcome of patients with this severe articular injury.