الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Ankle malleolar fractures represent one of the most frequent orthopedic traumatic injuries. They need appropriate management to restore the anatomical alignment of the ankle joint and regain its function. In order to achieve that the exact pattern of the fracture should be clearly identified which may become difficult with the ordinary plain radiographs alone.
The role of CT scan in managing ankle malleolar fractures had been discussed and evaluated before in order to reach an agreement about its effectiveness is such type of fractures. Those studies revealed its clinical importance in adjusting the managing plan but until now CT scan is not ordered routinely in all ankle malleolar fractures.
In our study we included 100 patients with ankle malleolar fractures that involved at least two malleoli. We ordered CT scan for each one of them then three observers were asked to make plan for each patient according to the plain x ray then according to the CT scan but in a random manner in another session to prevent the results from being biased.
Alteration in the management plan after reviewing the CT scan presented in 22 out of 100 cases. The change mainly affected the positon of the patient and the used approach followed by the implant for medial malleolus then posterior malleolus implant and finally the lateral malleolus implant. Missed injuries were discovered in 6 cases.
The change in plan was found mainly related to the number of the affected malleoli and the available plain radiographs on presentation but it also varied according to the classification of the fractures and the presence of dislocation.
Limitations of the study:
• The main limitation of the study that the plan for the implant used for each fracture can be modified intraoperatively according to the fracture pattern but we cannot ignore the role of preoperative planning. Because it might be easy to modify the implant but it is much more difficult to modify either the position or the approach intraoperatively.
• The questionnaire used