The safe zone of distal fibula was determined based on the classification of lateral malleolus fossa

• Published in: Journal of orthopaedic surgery and research Vol. 18; no. 1; pp. 1 - 9
• Main Authors: You, Gui-xuan, Huang, Lei, Li, Ming-hui, Xiong, Bin, Peng, Wan-lin, Shi, Hou-yin, Zhang, Lei
• Format: Journal Article
• Language: English
• Published: London BioMed Central 22.09.2023; BioMed Central Ltd; BMC
• Subjects: Ankle; Classification; Computed tomography; Fibula; Fibular fracture; Fractures; Internal fixation; Internal fixation in fractures; Lateral malleolar fossa; Ligaments; Medicine; Medicine & Public Health; Morphology; Orthopedics; Research Article; Software; Surgical Orthopedics; Lateral malleolar fossa; Ankle; Internal fixation; Fibular fracture
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-023-04194-6

Background Lateral malleolus fractures are very common, and the distal fibular geometry is complex. This study aimed to classify the lateral malleolus fossa (MF) into different types by characterizing the lateral MF imaging morphology and exploring the relationship between the lateral MF and internal fixation position after distal fibula fractures. Methods Anteroposterior CT reconstruction was performed on 248 subjects. After reconstruction, the deepest point of the lateral MF was located, and then, the cross-sectional shape of the lateral MF was observed and classified. Results According to the morphology of the CT cross section, the lateral MF was divided into three types: type C (43.1%), type V (32.2%), and type Flat (24.7%). Type V (3.98 ± 0.82) was significantly longer than type C(2.83 ± 0.54) and type Flat (1.84 ± 0.42) in cd. Similarly, in ∠α, Type Flat(136.31 ± 9.63) was the largest, followed by type C (116.51 ± 8.79), and type V (89.31 ± 9.07) was the smallest. Other measurements were not found any significant differences between the above. Conclusion According to the morphology of the CT cross section, the lateral MF was divided into three types: type C, type V and type Flat. Type V is most likely to be invaded when fixing the distal fibula. Screws less than 9 mm should be selected when fixing, and screws no more than 10 mm should be selected when there are type C and type Flat of MF.