Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

General Orthopaedics

The ability of junior surgical trainees to correctly assess adequacy of reduction following operative ankle fracture fixation

British Orthopaedic Association 2012 Annual Congress



Abstract

Background

The aim of our study was to assess the ability of orthopaedic surgical trainees to adequately assess ankle radiographs following operative fixation of unstable ankle fracture.

Methods and results

We identified 26 Supination-External rotation (SER) stage IV fractures, and 4 Pronation-External rotation (PER) stage III fractures treated surgically in our institution. Radiographs were evaluated for shortening of the fibula, widening of the joint space, malrotation of the fibula and widening of the medial clear space. Trainees were shown these radiographs and asked to comment on the adequacy of reduction. They were then given a simple tutorial on assessing adequacy of reduction and asked to reassess these radiographs. The parameters discussed included assessment of medial clear space, drawing of the tibiofibular line, use of the “circle sign” and measurement of the talocrural angle. There was a statistically significant improvement from 64% to 71.4% (P< 0.05) in the radiographs correctly assessed by orthopaedic trainees following a short tutorial on radiographical assessment.

Conclusions

Despite the frequency with which junior surgical trainees deal with ankle fractures, there is a lack of awareness on the objective means of adequately assessing ankle fracture fixation. We highlight this deficiency and demonstrate that a short tutorial on radiographic parameters results in improved assessment and better critical analysis of adequacy of reduction following ankle fracture fixation. As with fractures about the wrist, careful assessment of radiographic parameters should be considered standard practice in assessment of adequacy of reduction in fractures about the ankle.