Abstract

Background: There aren't many studies on the risk factors for tibial fractures with concealed posterior ankle fractures.

Objective: To research the prevalence and risk factors for tibial fractures in the presence of hidden posterior ankle fractures.

Methods: Patients with tibial fractures who were admitted to our hospital between January 2016 and May 2021 were prospectively chosen. General clinical information, X-ray images, CT images, and other imaging data were collected, and the patients were then divided into two groups based on the presence or absence of posterior malleolus fractures: the posterior malleolus fracture group and the nonposterior malleolus fracture group.

Results: Among the 186 patients with tibial fractures, CT revealed that 25 (13.44%) patients had concealed posterior ankle fractures. Gender, age, and the sites of the tibial fracture did not significantly differ between the two groups (P > 0.05). The types, locations, and lengths of patients with tibial fractures but no posterior malleolus fractures showed statistical differences. The difference in +e length between the tibia fracture group and the tibia with posterior ankle fracture group was statistically significant (P 0.05). The AUC of the length of the tibial fracture with concealed posterior ankle fracture was 0.599, according to the +e ROC curve. The best cut point for the prediction of tibial fracture with concealed posterior ankle fracture, according to the +e YD index, was over 13.18%. In comparison to tibial fracture length, the sensitivity and specificity of spiral tibial fracture and distal third tibial fracture for prediction were significantly higher at 88.00% and 63.35%, 92.00%, and 58.39%, respectively (P 0.05).

Conclusion: Occult posterior ankle fractures are more common in patients with tibial fractures. With occult posterior ankle fractures, spiral and distal third tibial fractures have a greater predictive value for tibial fractures and can aid in early clinical identification for more accurate and suitable treatment.