{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:07:55Z","timestamp":1777615675885,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>For rotational ankle fractures with a posterior malleolus fracture (PMF), the decision to further evaluate the ankle injury with computed tomography (CT) is challenging. The objective of this study is to determine how well PMF fracture size on x-rays correlates with size on CT, and how well x-rays can predict which patients receive PMF fixation after CT review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective study of adult ankle fractures with PMFs that had preoperative radiographs and CT imaging over a 5-year period. PMF x-ray and CT measurements were recorded, and relationships between x-ray measurements and final PMF fixation plan after CT review were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 98 patients were identified with both x-rays and preoperative CT imaging. Pearson\u2019s rank correlation demonstrated a strong relation between PMF width percentage measured on x-ray and CT (r = 0.724). Of the 45 patients with a PMF size under 20% on x-ray, only one patient (with an apparent incarcerated fragment) underwent PMF fixation after review of the CT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PMF width on lateral x-ray correlates well with CT size and is sensitive for predicting the need for dedicated posterior malleolus based on one institutional practice pattern. Below 20% fracture width on lateral x-ray, a dedicated CT rarely leads to a decision to perform PMF fixation. Limiting pre-operative CT to those with PMF width &gt;20% could reduce CT utilization by as much as 45% without negatively affecting patient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Levels of Evidence:<\/jats:title>\n                    <jats:p>Level III: Diagnostic<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19386400221128159","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T05:26:14Z","timestamp":1665465974000},"page":"585-591","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Can Lateral X-Rays Reliably Determine Which Posterior Malleolus Ankle Fractures Need a CT?"],"prefix":"10.1177","volume":"17","author":[{"given":"Ayush","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Massachusetts, Worcester, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Fredette","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Massachusetts, Worcester, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Massachusetts, Worcester, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Curtin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Massachusetts, Worcester, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9801-5101","authenticated-orcid":false,"given":"Eric","family":"Swart","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Lahey Hospital &amp; Medical Center, Burlington, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,10,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679809002355."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2016.08.004."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2015.04.001."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199173030-00005."},{"key":"e_1_3_2_6_2","first-page":"96","article-title":"Posterior malleolar ankle fractures: an in vitro biomechanical analysis of stability in the loaded and unloaded states","volume":"6","author":"Scheidt KB","year":"1992","unstructured":"Scheidt KB, Stiehl JB, Skrade DA, Barnhardt T. Posterior malleolar ankle fractures: an in vitro biomechanical analysis of stability in the loaded and unloaded states. J Orthop Trauma. 1992;6:96-101.","journal-title":"J Orthop Trauma"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1097\/00003086-199511000-00030","article-title":"Tibiotalar contact area. Contribution of posterior malleolus and deltoid ligament","volume":"320","author":"Hartford JM","year":"1995","unstructured":"Hartford JM, Gorczyca JT, McNamara JL, Mayor MB. Tibiotalar contact area. Contribution of posterior malleolus and deltoid ligament. Clin Orthop Relat Res. 1995;320:182-187.","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198911000-00018"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198870090-00012"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2014.06.015."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0385."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713475355."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181e4f81e."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-012-1591-9."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e31819b0b23."},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.99B11.BJJ-2017-1072."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.07.019."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717732746."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717731568."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2019.08.007."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199408000-00009."},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.00856."},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717719533."}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400221128159","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19386400221128159","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400221128159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:32:01Z","timestamp":1777411921000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19386400221128159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,11]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1177\/19386400221128159"],"URL":"https:\/\/doi.org\/10.1177\/19386400221128159","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,11]]}}}