All Ankle Fractures Should Be Assessed With CT Scans  

Description

In a compelling presentation, Anthony Sakellariou discusses the role of computed tomography (CT) in assessing ankle fractures, challenging the conventional reliance on X-rays alone for diagnosis and treatment planning. He begins by admitting his typical role as a heckler turned speaker, addressing the controversial stance on the necessity of CT scans for various types of ankle fractures. Sakellariou emphasizes the complexity of ankle injuries, particularly the importance of understanding fracture stability, which can be assessed through CT imaging.



He introduces key concepts like the ring model of the ankle, the Lauge-Hansen classification for injury mechanisms, and the distinctions between stable and unstable fractures. By dissecting specific fracture types, such as Weber-A and Weber-B fractures, he articulates how certain injuries may appear stable initially but could still harbor underlying complexities, such as osteochondral injuries or partial ligament disruptions that are often missed on simple X-rays.



Sakellariou highlights the importance of CT imaging in preoperative planning and assessing syndesmotic injuries, advocating for its use in cases where instability or additional fractures may not be apparent. He cautions against the reliance on medial clinical signs alone for determining fracture stability, as this approach risks unnecessary surgeries on stable injuries.



Throughout the discussion, he underscores the need for accurate diagnostics, arguing that CT scans should be routinely used to ensure comprehensive treatment of ankle fractures. The presentation concludes with a call for a paradigm shift in how clinicians approach fracture treatment, favoring a thorough investigation and identification of all injury components through advanced imaging techniques.

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