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A higher association of medial collateral ligament injury of the knee in pronation injuries of the ankle

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

To evaluate the prevalence of medial collateral ligament (MCL) injury of the knee among ankle-fracture patients and to determine the risk factors associated with MCL injury in this patient group.

Materials and methods

303 patients (303 affected ankles) who underwent surgical treatment for an ankle fracture were assessed. Supination versus pronation injury, Danis-Weber classification, age, sex, body mass index (BMI), limb dominance, and mechanism of injury were reviewed to identify factors related to MCL injury.

Results

Prevalence of MCL injury of the knee among the total number of patients with an ankle fracture was 3.96% (12 out of 303 injuries). Multivariable logistic and linear regression analysis with adjustment of possible confounding factors confirmed that female sex and pronation injury were associated significantly (p < 0.05) with MCL injury.

Conclusions

The prevalence of MCL injury among females and the pronation type of ankle injury was 8.19% (10 out of 122 females) and 10.75% (10 out of 93 pronation injuries), respectively. More careful physical examination of the knee joint is strongly recommended in patients with ankle fractures, especially if the patient is female or the ankle-fracture pattern corresponds to the pronation type of injury.

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References

  1. Westerman RW, Porter K (2007) Ankle fractures in adults: an overview. Trauma 9:267–272

    Article  Google Scholar 

  2. Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37:691–697

    Article  PubMed  Google Scholar 

  3. Belatti DA, Phisitkul P (2014) Economic burden of foot and ankle surgery in the US Medicare population. Foot Ankle Int 34:334–340

    Article  Google Scholar 

  4. Toole WP, Elliott M, Hankins D, Rosenbaum C, Harris A, Perkins C (2015) Are low-energy open ankle fractures in the elderly the new geriatric hip fracture? J Foot Ankle Surg 54:203–206

    Article  PubMed  Google Scholar 

  5. Lauge-Hansen N (1950) Fractures of the ankle: II. Combined experimental surgical and experimental-roentgenologic investigations. Arch Surg 60:957–985

    Article  PubMed  CAS  Google Scholar 

  6. Michelson J, Solocoff D, Waldman B, Kendell K, Ahn U (1997) Ankle fractures: the Lauge-Hansen classification revisited. Clin Orthop Relat Res 345:198–205

    Article  Google Scholar 

  7. Rodriguez EK, Kwon JY, Herder LM, Appleton PT (2013) Correlation of AO and Lauge-Hansen classification systems for ankle fractures to the mechanism of injury. Foot Ankle Int 34:1516–1520

    Article  PubMed  Google Scholar 

  8. Haraguchi N, Armiger RS (2009) A new interpretation of the mechanism of ankle fracture. J Bone Jt Surg Am 91:821–829

    Article  Google Scholar 

  9. Valentin A Jr, Patel SP, Weaver MJ et al (2016) Relevance of adjacent joint imaging in the evaluation of ankle fractures. Injury 47:2366–2369

    Article  Google Scholar 

  10. Powers CM (2003) The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther 33(11):639–646

    Article  PubMed  Google Scholar 

  11. Dold AP, Swensen S, Strauss E, Alaia M (2017) The posteromedial corner of the knee: anatomy, pathology, and management strategies. J Am Acad Orthop Surg 25:752–761

    Article  PubMed  Google Scholar 

  12. Chen L, Kim PD, Ahmad CS, Levine WN (2008) Medial collateral ligament injuries of the knee: current treatment concepts. Curr Rev Musculoskelet Med 1:108–113

    Article  PubMed  Google Scholar 

  13. Narvani A, Mahmud T, Lavelle J et al (2010) Injury to the proximal deep medial collateral ligament. Bone Jt J 92-B:949–953

    Article  Google Scholar 

  14. DeLong JM, Wterman BR (2015) Surgical repair of medial collateral ligament and posteromedial corner injuries of the knee; a systematic review. Arthroscopy 31(11):2249–2255

    Article  PubMed  Google Scholar 

  15. Fanelli GC, Harris JD (2006) Surgical treatment of acute medial collateral ligament and posteromedial corner injuries of the knee. Sports Med Arthrosc 14:78–83

    Article  PubMed  Google Scholar 

  16. Danis R (1949) Les fractures malleolaires. In: Danis R (ed) Theorie et pratique de l’osteosynthese. Masson, Paris

    Google Scholar 

  17. Weber BG (1972) Die verletzungen des oberen sprunggelenkes, 2nd edn. Verlag Hans Huber, Berne

    Google Scholar 

  18. Delong JM, Waterman BR (2015) Surgical repair of medial collateral ligament and posteromedial corner injuries of the knee: a systematic review. Arthroscopy 31(11):2249–2255

    Article  PubMed  Google Scholar 

  19. Halinen J, Lindahl J, Hirvensalo E (2009) Range of motion and quacriceps muscle power after surgical treatment of acute combined anterior cruciate and grade-III medial collateral ligament injuries. A prospective randomized study. J Bone Jt Surg Am 91:1305–1312

    Article  Google Scholar 

  20. Pott P (2007) Some few general remarks on fractures and dislocations:1758. Clin Orthop Relat Res 458:40–41

    Article  PubMed  Google Scholar 

  21. Warner SJ, Garner MR, Hinds RM et al (2015) Correlation between the Lauge-Hansen classification and ligament injuries in ankle fractures. J Orthop Trauma 29–12:574–578

    Article  Google Scholar 

  22. Miyamoto RG, Bosco JA, Sherman OH (2009) Treatment of medial collateral ligament injuries. J Am Acad Orthop Surg 17:152–161

    Article  PubMed  Google Scholar 

  23. Roach CJ, Haley CA, Cameron KL et al (2014) The epidemiology of medial collateral ligament sprain in young athletes. Am J Sports Med 42 – 5:1103–1109

    Article  Google Scholar 

  24. Bradley J, Honkamp NJ, Jost P, West R, Norwig J, Kaplan LD (2008) Incidence and variance of knee injuries in elite college football players. Am J Orthop 37:310–314

    PubMed  Google Scholar 

  25. Majewski M, Susanne H, Klaus S (2006) Epidemiology of athletic knee injuries: a 10-year study. Knee 13:184–188

    Article  PubMed  CAS  Google Scholar 

  26. Myklebust G, Enqebretsen L, Braekken IH et al (2003) Prevention of anterior cruciate ligament injuries in female team handball players: a prospective intervention study over three seasons. Clin J Sport Med 13–2:71–78

    Article  Google Scholar 

  27. Zelisko JA, Noble HB, Porter M (1982) A comparison of men’s and women’s professional basketball injuries. Am J Sports Med 10:297–299

    Article  PubMed  CAS  Google Scholar 

  28. Stanley LE, Kerr ZY, Dompier TP, Padua DA (2016) Sex differences in the incidence of anterior cruciate ligament, medial collateral ligament, and meniscal injuries in collegiate and high school sports: 2009–2010 through 2013–2014. Am J Sports Med 44(6):1565–1572

    Article  PubMed  Google Scholar 

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Author notes

  1. Il-Hoon Sung and Kyu-Tae Hwang contributed equally.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hanyang University Hospital, Seoul, South Korea

    Kyu-Tae Hwang, Il-Hoon Sung, Jung-Hwan Choi & Jin Kyu Lee

Authors
  1. Kyu-Tae Hwang
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  2. Il-Hoon Sung
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  3. Jung-Hwan Choi
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Correspondence to Jin Kyu Lee.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individuals included in the study.

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Hwang, KT., Sung, IH., Choi, JH. et al. A higher association of medial collateral ligament injury of the knee in pronation injuries of the ankle. Arch Orthop Trauma Surg 138, 771–776 (2018). https://doi.org/10.1007/s00402-018-2907-z

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  • DOI: https://doi.org/10.1007/s00402-018-2907-z

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