This scientific poster presents a study in which malleolar fractures were generated during impact testing of the cadaver foot and ankle complex. Impact conditions were characteristic of those observed in frontal crashes and included 4 loading scenarios: pure blunt axial loading, dorsiflexion induced by forefoot impact loading, dorsiflexion and axial loading induced by midfoot impact loading, and pure eversion loading. All the specimens underwent post-test radiographic examination and a necropsy. Eighteen malleolar fractures from the tests were randomly divided into two groups. Radiographs and necropsy reports were supplied to 4 orthopaedic specialists with a questionnaire. They were asked to identify the primary direction of the deforming force, which caused the injury, and to code each fracture using OTA/AO fracture coding and Lauge-Hansen classification scheme. It appeared, for instance, that 12 of the 18 malleolar fractures were generated by axial loading. This is believed to be the first study to assess the ability of the orthopaedic specialist to retrospectively elucidate the malleolar fracture mechanism in impact environment and compare it with the known fracture mechanism. The study revealed that the ability of the orthopaedic specialists to retrospectively elucidate fracture mechanism from radiographs and soft tissue injury in an impact environment was limited.
Abstract