Radiological Characteristics and Injury Mechanism of Logsplitter Injury: A Descriptive and Retrospective Study

Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: Logsplitter Injury is a type of high-energy ankle fracture dislocation. The mechanism of injury has not been described in detail. A detailed understanding of the radiological features and pathological changes can further guide treatment. Methods: Between April 2009 and December 2018, a retrospective analysis was conducted on 62 patients with Logsplitter injury. The study analysed the characteristics of fbular injury, tibial injury, syndesmosis injury, medial injury and lateral ligament injury on preoperative X-ray and CT scans. The incidence of the diferent injury types was summarised. The correlation between Logsplitter injuries and the mechanisms causing them were analysed using the Lauge-Hansen classifcation of ankle fractures. Results: According to the Radiological, we divided them into fibula injury, tibial injury, syndesmosis injury, medial injury including the medial malleolus fracture/deltoid ligament rupture, and lateral Injury is lateral collateral ligament rupture. After analyzing different types of ankle fractures in logsplitter injuries based on Lauge Hansen's classification, it was found that rotational anterior abduction was the predominant pattern. Based on these injury characteristics, a typology on Logsplitter injuries was proposed, with open injuries being type A and closed injuries being type B. Based on the fracture morphology it was categorized into 4 middle types. According to the available follow-up results, A1 and A4 have better prognosis than A2 and A3. Conclusion: The pathoanatomic characteristics of Logsplitter injury are diverse, with some cases accompanied by collateral ligament injury. It is important to note that these evaluations are objective and based on current results. The most common injury mechanism is vertical violence combined with abduction, although in some cases, it may be a vertical combined external-rotation injury.