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Continuous spectrum in Haraguchi fracture types seen in malleolar fracture mapping
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The mapping of posterior malleolar fractures demonstrated a continuous spectrum between Haraguchi I and Haraguchi III fractures and the Haraguchi II fracture type was identified in this study as a separate pattern.
Researchers retrospectively evaluated radiographs and CT scans of 45 patients with fractures with posterior malleolar fragments. They used the Lauge-Hansen and Danis-Weber classification systems to categorize the fractures and a quantitative 3-D CT model to calculate fracture maps, fragment volume, articular surface of the posterior malleolar fragment, articular surface of the intact tibia and articular surface of the medial malleolus.
The researchers also used the interclass correlation coefficient to measure interobserver reliability of the quantitative 3-D CT model.
Results from the fracture mapping showed a continuous spectrum from the Haraguchi type III fracture to the Haraguchi type I fracture with no visible cutoff between them. The results also showed one and two piece transverse fractures of the posterior rim of the tibial plafond, even for Haraguchi type II fractures.
The posterior malleolar fracture pathoanatomy and the Lauge-Hansen ankle fracture patterns overall were not associated, according to the study results.
Measurements for reliability of the volume and the articular surface of posterior malleolar fracture fragments was categorized based on the Landis classification system as nearly perfect. Haraguchi fracture types I and III were significantly different with regards to posterior malleolar fragment size, articular involvement and 3-D fragment morphology, according to researchers. ‒ by Monica Jaramillo
Disclosures: Mangnus reports no relevant financial disclosures. Please see the full study for a full list of all other author’s relevant financial disclosures.
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