Weightbearing Radiography and MRI Findings in Ankle Fractures.

Bäcker, Henrik C.; Vosseller, J Turner; Bonel, Harald; Cullmann-Bastian, Jennifer; Krause, Fabian; Attinger, Marc C. (2021). Weightbearing Radiography and MRI Findings in Ankle Fractures. Foot & ankle specialist - FAS, 14(6), pp. 489-495. Sage 10.1177/1938640020921571

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Background. Static weightbearing radiography can be used to assess stability in ankle fractures by measuring lateral talar shift (medial clear space; MCS). However, the correlation of a stable ankle joint under weightbearing load and the structural integrity of the deltoid ligament has not been shown. In this study, we assessed deltoid ligament integrity on magnetic resonance imaging (MRI) and correlated that with weightbearing and gravity stress test radiography. Methods. Thirty-four patients with supination external rotation II-IV (SER) fractures underwent MRI, weightbearing radiography, and gravity stress test. On MRI, the deep anterior and posterior tibiotalar deltoid, tibionavicular and tibiocalcaneal ligaments, as well as the syndesmosis were assessed as intact, partial rupture, or complete rupture. The MCS was measured as the distance between the lateral border of the medial malleolus and the medial border of the talus at the level of the talar dome on the mortise view. Results. Twenty-three patients suffered a deep anterior tibiotalar ligament rupture (16 partial; 7 complete) and 2 a deep posterior tibiotalar ligament tear (1 partial; 1 complete). For MCS on weightbearing radiography, no statistically significant differences were identified between any of the individual groups. With gravity stress radiography, only a complete tear of the tibiocalcaneal ligament showed a significantly higher MCS than a partial tear or intact tibiocalcaneal ligament (P < .005). No other ligament disruption showed a significant difference between the complete rupture versus intact or partial tear. Conclusion. Weightbearing radiography does not show much variation in terms of MCS even with ligamentous disruption and fibula fracture. The talus often centers itself underneath the tibia with weightbearing radiography. Levels of Evidence: Level III: Retrospective cohort study.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Bäcker, Henrik Constantin; Krause, Fabian and Attinger, Marc Claudio


600 Technology > 610 Medicine & health








Kathrin Aeschlimann

Date Deposited:

28 Dec 2020 18:58

Last Modified:

02 Dec 2021 00:11

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

MRI Weber B ankle fracture radiography stability assessment weightbearing



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