SynthesisJournal of orthopaedic surgery and research2021
Incidence and missed diagnosis risk of occult posterior malleolar fractures associated with the tibial shaft fractures: a systematic review.
Synthesis in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- Plain X-ray is insufficient for correct diagnosis of tibial shaft spiral fractures: a prospective trial.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Trial
- What is the desired screw trajectory for fixation of noncontiguous posterior distal articular fractures associated with distal tibial shaft fractures?OTA international : the open access journal of orthopaedic trauma · 2026Article
- Article
- Prevalence and risk factors of concomitant malleolar and fibular fractures in patients with distal spiral tibial shaft fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Can we predict size, Haraguchi type and preoperative displacement of posterior malleolar fractures in association with tibial shaft fractures?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- Prediction of distal tibial articular extension in tibial shaft fractures: both posterior malleolar fracture and non posterior malleolar fracture intra-articular extension.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Incidence and Predictive Factors of Tibial Fracture with Occult Posterior Ankle Fractures.Journal of healthcare engineering · 2021Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundTibial shaft fractures (TSFs) combined with occult posterior malleolar fractures (PMFs) are becoming widely recognized in the field of orthopedics. The purpose of this study was to determine the clinical incidence, missed diagnosis rate, and treatment strategies of this combined injury.
methodsPubMed, Cochrane, and MEDLINE Ovid databases were searched for articles of English language from 1988 to 2020, identifying 1549 papers.
resultsTwenty-one of the 1278 identified studies were eligible for inclusion. Each study reported on the incidence of this combined injury, and 12 studies documented the missed diagnosis rate. Seventeen studies reported surgical intervention strategies for PMFs. In the present review, PMFs frequently occurred in spiral TSFs (70%), especially distal third spiral TSFs (70.4%), based on CT scans or additional MRI. Based on the original X-ray detection, approximately 50% of PMFs were missed in patients with a combined injury. In addition, the treatment strategies for PMFs were inconsistent. Most studies (11/17) believe that specific surgical management needs to be developed based on the fragment size, displacement, and stability of the PMF.
conclusionsFor patients with TSFs, spiral TSFs, especially distal third spiral TSFs, are closely related to PMFs and are often not sufficiently diagnosed by X-ray alone. Advanced CT and MRI examinations can significantly reduce the missed diagnosis rate of occult PMFs. According to available literature, the treatment strategy for PMFs associated with TSFs is questionable without convincing evidence of benefit.
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