Morphological and clinical study of lateral malleolus fractures based on fracture mapping: a retrospective study.

Background: The traditional classification for lateral malleolus fracture has its limitations. In this study, we introduced a three-dimensional (3D) fracture mapping technique using computed tomography (CT) data to assess fracture line distributions and their impact on patient outcomes, offering a refined classification approach.

Methods: Retrospectively, we analysed 97 patients who underwent lateral malleolus fracture surgeries (2014-2019), using CT Digital Imaging and Communications in Medicine data to create 3D models and fracture maps. This methodology refined the Danis-Weber classification and enabled the assessment of fracture severity and syndesmotic stability through clinical scoring.

Results: Danis-Weber type B fractures were predominant (83.5%), showing a distinct pattern. Subtypes were identified based on the bone fragments that are clinically associated with increased injury severity but did not significantly affect syndesmotic stability or prognostic scores.

Conclusion: The 3D fracture map provides a detailed view of fracture characteristics, enabling precise classification. In type B fractures, bone fragments indicating higher trauma do not predict clinical outcomes, thereby supporting personalised surgical planning.