Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign

<h3>Introduction</h3><p dir="ltr">Talus fractures are not uncommon and one of the serious fractures in the foot and ankle. Peroneal tendon dislocation is one of the commonly missed soft tissue injuries which may have significant impact on the outcomes including persistent...

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التفاصيل البيبلوغرافية
المؤلف الرئيسي: Ahmed Khalil Attia (10334814) (author)
مؤلفون آخرون: Karim Mahmoud (7304036) (author), Tarek Taha (2863076) (author), Osama AlDahamsheh (14150253) (author), Ahmed Hany ElHessy (14150256) (author), Ahmad S. AlObaidi (14150259) (author), Mohammed M. Mekhaimar (14150262) (author)
منشور في: 2020
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_version_ 1864513568092717056
author Ahmed Khalil Attia (10334814)
author2 Karim Mahmoud (7304036)
Tarek Taha (2863076)
Osama AlDahamsheh (14150253)
Ahmed Hany ElHessy (14150256)
Ahmad S. AlObaidi (14150259)
Mohammed M. Mekhaimar (14150262)
author2_role author
author
author
author
author
author
author_facet Ahmed Khalil Attia (10334814)
Karim Mahmoud (7304036)
Tarek Taha (2863076)
Osama AlDahamsheh (14150253)
Ahmed Hany ElHessy (14150256)
Ahmad S. AlObaidi (14150259)
Mohammed M. Mekhaimar (14150262)
author_role author
dc.creator.none.fl_str_mv Ahmed Khalil Attia (10334814)
Karim Mahmoud (7304036)
Tarek Taha (2863076)
Osama AlDahamsheh (14150253)
Ahmed Hany ElHessy (14150256)
Ahmad S. AlObaidi (14150259)
Mohammed M. Mekhaimar (14150262)
dc.date.none.fl_str_mv 2020-03-17T21:00:00Z
dc.identifier.none.fl_str_mv 10.1007/s00264-020-04534-9
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Peroneal_tendon_dislocation_in_talus_fracture_and_diagnostic_value_of_fleck_sign/21596967
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Talus
peroneal tendons
hindfoot
fracture
fleck sign
dc.title.none.fl_str_mv Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Introduction</h3><p dir="ltr">Talus fractures are not uncommon and one of the serious fractures in the foot and ankle. Peroneal tendon dislocation is one of the commonly missed soft tissue injuries which may have significant impact on the outcomes including persistent pain and swelling. They have been reported to be associated with calcaneum as well as talus fractures.</p><h3>Aim</h3><p dir="ltr">To report the incidence of peroneal tendon dislocation in talus fracture and the significance of fleck sign in the diagnosis of peroneal tendon dislocation.</p><h3>Methods</h3><p dir="ltr">We retrospectively reviewed 93 consecutive talus fractures in the period between 1/1/2011 to 1/11/2018. Inclusion criteria were: The patient underwent open reduction and internal fixation, had pre-operative CT scan that is available for review and three view ankle plain radiographs. Two independent authors review the radiographs for peroneal tendon dislocation, fleck sign and fracture classification, if any. Any dispute was resolved by the senior author. Patient records were reviewed for laterality, age, sex, mode of injury, associated injuries and operative interventions. 50 ankles met the inclusion criteria. 49 were males, mean age was 32.5 year and the predominant mode of injury was a fall from height.</p><h3>Results</h3><p dir="ltr">Peroneal tendon dislocation was found in ten patients out of 50 (20%). Risk of dislocation increased with severity of the fracture and neck fractures. Most of the dislocations were missed by surgeons and radiologist, and no additional procedures were done to address such an injury. The Fleck sign had a statistically significant correlation with peroneal tendons dislocations (p=.005)</p><h3>Conclusion</h3><p dir="ltr">Peroneal tendons dislocation is associated with as high as 20% of talus fractures. The authors recommend carefully reviewing CT scans by surgeons and radiologists alike to avoid missing such injury and allow for appropriate surgical approach utilization. The Fleck sign is a highly specific radiographic sign that has a statistically significant correlation with PT dislocation and hence we recommend intra-operative assessment of peroneal tendons in patients with the fleck sign.</p><h2>Other Information</h2><p dir="ltr">Published in: International Orthopaedics<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1007/s00264-020-04534-9" target="_blank">http://dx.doi.org/10.1007/s00264-020-04534-9</a></p>
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oai_identifier_str oai:figshare.com:article/21596967
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spelling Peroneal tendon dislocation in talus fracture and diagnostic value of fleck signAhmed Khalil Attia (10334814)Karim Mahmoud (7304036)Tarek Taha (2863076)Osama AlDahamsheh (14150253)Ahmed Hany ElHessy (14150256)Ahmad S. AlObaidi (14150259)Mohammed M. Mekhaimar (14150262)Biomedical and clinical sciencesClinical sciencesTalusperoneal tendonshindfootfracturefleck sign<h3>Introduction</h3><p dir="ltr">Talus fractures are not uncommon and one of the serious fractures in the foot and ankle. Peroneal tendon dislocation is one of the commonly missed soft tissue injuries which may have significant impact on the outcomes including persistent pain and swelling. They have been reported to be associated with calcaneum as well as talus fractures.</p><h3>Aim</h3><p dir="ltr">To report the incidence of peroneal tendon dislocation in talus fracture and the significance of fleck sign in the diagnosis of peroneal tendon dislocation.</p><h3>Methods</h3><p dir="ltr">We retrospectively reviewed 93 consecutive talus fractures in the period between 1/1/2011 to 1/11/2018. Inclusion criteria were: The patient underwent open reduction and internal fixation, had pre-operative CT scan that is available for review and three view ankle plain radiographs. Two independent authors review the radiographs for peroneal tendon dislocation, fleck sign and fracture classification, if any. Any dispute was resolved by the senior author. Patient records were reviewed for laterality, age, sex, mode of injury, associated injuries and operative interventions. 50 ankles met the inclusion criteria. 49 were males, mean age was 32.5 year and the predominant mode of injury was a fall from height.</p><h3>Results</h3><p dir="ltr">Peroneal tendon dislocation was found in ten patients out of 50 (20%). Risk of dislocation increased with severity of the fracture and neck fractures. Most of the dislocations were missed by surgeons and radiologist, and no additional procedures were done to address such an injury. The Fleck sign had a statistically significant correlation with peroneal tendons dislocations (p=.005)</p><h3>Conclusion</h3><p dir="ltr">Peroneal tendons dislocation is associated with as high as 20% of talus fractures. The authors recommend carefully reviewing CT scans by surgeons and radiologists alike to avoid missing such injury and allow for appropriate surgical approach utilization. The Fleck sign is a highly specific radiographic sign that has a statistically significant correlation with PT dislocation and hence we recommend intra-operative assessment of peroneal tendons in patients with the fleck sign.</p><h2>Other Information</h2><p dir="ltr">Published in: International Orthopaedics<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1007/s00264-020-04534-9" target="_blank">http://dx.doi.org/10.1007/s00264-020-04534-9</a></p>2020-03-17T21:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s00264-020-04534-9https://figshare.com/articles/journal_contribution/Peroneal_tendon_dislocation_in_talus_fracture_and_diagnostic_value_of_fleck_sign/21596967CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/215969672020-03-17T21:00:00Z
spellingShingle Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign
Ahmed Khalil Attia (10334814)
Biomedical and clinical sciences
Clinical sciences
Talus
peroneal tendons
hindfoot
fracture
fleck sign
status_str publishedVersion
title Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign
title_full Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign
title_fullStr Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign
title_full_unstemmed Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign
title_short Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign
title_sort Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign
topic Biomedical and clinical sciences
Clinical sciences
Talus
peroneal tendons
hindfoot
fracture
fleck sign