Local Bone Dencity in Neglected Ankle Fractures

Abstract

   Objective: determining the neglected ankle fractures clinical stages based on the analysis of computed tomograms (CT) at various time from the injury and radiological findings in different types of ankle injury.   Material and methods. An open randomized multicenter study included 48 patients with Weber type B and C ankle fractures (15 males, 33 females) aged from 27 to 68 years old (mean age 45 years old). The result of the CT analysis for each patient was the ratio of bone density on the damaged side to the bone density of the intact ankle. Next, the correlation was defined between the attitude and time from injury (in days) as well as diastasis (in millimeters) and age (in years).   Results. Mean bone density in the period up to 15 days was 403.25 ± 63.74 HU, in the period between 15 and 32 days – 359.85 ± 71.34 HU, in the period more than 32 days – 271.91 ± 73.34 HU. Local bone density is inversely proportional to the time from injury (correlation coefficient –0.678) and the fracture gap (correlation coefficient –0.396). There was no significant dependence of local bone density on the patient’s age (correlation coefficient –0.177). Local bone density significantly (p = 0.05) decreased in the period of more than 14 days from the injury and was 80% and less from intact bone density in the period of more than 32 days from the injury (p = 0.0004). Signs of fracture healing appeared, in average, on the 28 th day after the injury with the fracture gap less than 1 mm.   Conclusion. From the point of view of preoperative planning, neglected ankle fractures bone density critical points are 14 th and 32 nd days after injury.