Background: Skeletally immature children with ankle sprain are presumed to have distal fibula fracture than ligamentous injury. The purpose of this study is to determine the incidence of associated occult avulsion fracture in children with lateral ankle sprain and the efficacy of identifying fractures using anterior talofibular ligament view.
Methods: Patients who were diagnosed with distal fibular fracture in the initial ankle anteroposterior, lateral, and mortise were excluded and 78 patients (below 16 y of age) who had been initially diagnosed as ankle sprain were included. The initial and 4 weeks' follow-up ankle series and additional anterior talofibular ligament view suggested by Haraguchi were evaluated.
Results: Twenty patients were diagnosed with occult distal fibular avulsion fracture. Ten patients were diagnosed in anterior talofibular ligament view and others were diagnosed in the follow-up radiography. Displacement was highest on the anterior talofibular ligament view.
Conclusions: This study found 20 (26%) of 78 ankle sprain show occult avulsion fracture in the anterior talofibular ligament view or follow-up radiography. The anterior talofibular ligament view is an appropriate radiologic view for the diagnosis of distal fibular avulsion fracture.
Level Of Evidence: Level IV--diagnostic study.
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Article Synopsis
- The anterior talofibular ligament (ATFL) is the most commonly injured ligament in ankle sprains, with many patients recovering conservatively but a significant portion developing chronic instability requiring surgery.
- A study involving healthy volunteers and patients with sprained ankles used 3D MRI to create anatomical models of the ATFL and evaluated the feasibility and image quality of these models for better understanding of injuries and surgical planning.
- Results showed high image quality scores for the 3D models, indicating that 3D MRI can accurately represent ATFL anatomy, which could enhance preoperative strategy and improve diagnosis and treatment decisions.
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