The radiographic appearance of the distal tibia after fracture reduction can be classified for adequacy based on the relationships between the bone fragments.
Parameters:
(1) lateral displacement of medial malleolus
(2) medial displacement of the medial malleolus
(3) proximal displacement of the medial malleolus
(4) mortise widening
(5) tilt of the talus
(6) talus displacement
where:
• Mortise widening appears to refer to the relationship between the distal tibia and the talus since it resembles a mortise joint.
Parameters
Adequacy of Fracture Reduction
Good
Fair
Poor
lateral displacement
anatomic or <= 2.0 mm
2.01 - 5.0 mm
> 5.0 mm
medial displacement
<= 2.0 mm
2.01 - 5.0 mm
> 5.0 mm
proximal displacement
<= 2.0 mm
2.01 - 5.0 mm
> 5.0 mm
mortise widening
<= 0.5 mm
0.51 - 2.0 mm
> 2.0 mm
tilt of the talus
<= 0.5 mm
0.51 - 1.0 mm
> 1.0 mm
talus displacement
<= 0.5 mm
0.51 - 2.0 mm
> 2.0 mm
from Table I, page 544
where:
• For lateral displacement, the original table has good displacement <= 1.0 mm and fair displacement 2.0 - 5.0 mm. One or the other appears to be a misprint. I opted for the latter since it matched the pattern shown by the other parameters.
• The table shows overlap between the measurements of good and fair reduction (for example good is <= 2.0 and fair is 2.0+). I modified the table to remove the overlap.
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