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Objectives <p>To evaluate, using ultrasonography and the AOFAS (The American Orthopaedic Foot and Ankle Society) score, changes in the peroneal tendons of patients with ankle fractures resulting from a supination-external rotation (SER) mechanism treated with either lateral or posterolateral plate fixation.</p> Methods <p>This retrospective observational study was conducted at a tertiary level III trauma center. Adult patients (&gt;&#xa0;18&#xa0;years) with unilateral SER ankle fractures, a minimum follow-up of 1&#xa0;year, no persistent symptoms, and fixation using a 1/3 tubular 3.5-mm locking plate (lateral or posterolateral) were included. Exclusion criteria comprised bilateral injuries, Weber A/C fractures, pathological fractures, previous ankle disorders, infection, postoperative pain, or functional limitations. The primary outcomes were peroneal tendon thickness on ultrasonography and functional performance assessed using the AOFAS Ankle-Hindfoot Scale. Outcomes were compared between fixation techniques.</p> Results <p>Seventy-six patients were included (65.8% aged 35–64&#xa0;years, 60.5% women, 53.9% left-sided injuries). In most cases (71.1%), tendon thickness was greater on the operated side. Posterolateral plating demonstrated a higher frequency of positive tendon-thickness differences. Most differences measured 0–2&#xa0;mm (56.6%), with a statistically significant difference between lateral and posterolateral fixation groups (<i>p</i> &lt; 0.001). AOFAS scores were high in both groups, indicating satisfactory postoperative functional outcomes.</p> Conclusions <p>A difference in peroneal tendon thickness between the operated and contralateral sides was observed in 89.5% of patients, and these differences were significantly greater after posterolateral plating. Although plate position directly influenced postoperative tendon thickness, no clinically relevant consequences were identified.</p> <i>Level of evidence</i> <p>Level III.</p>

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Posterolateral plating increases peroneal tendon thickness without affecting clinical outcomes: a ultrasonographic comparative study of 76 SER ankle fractures

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  • 发表日期：

    2026年4月24日

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  • Pedro José Labronici,
  • Jonas Pessoa de Campos,
  • João Pedro de Araújo Almeida,
  • William Dias Belangero,
  • Gustavo Waldolato,
  • Robinson Esteves Pires,
  • Antônio Tufi Neder Filho,
  • Túlio Vinícius de Oliveira Campos,
  • David Rojas,
  • Anderson Freitas,
  • Vincenzo Giordano,
  • Alexandre Leme Godoy-Santos

摘要

Objectives

To evaluate, using ultrasonography and the AOFAS (The American Orthopaedic Foot and Ankle Society) score, changes in the peroneal tendons of patients with ankle fractures resulting from a supination-external rotation (SER) mechanism treated with either lateral or posterolateral plate fixation.

Methods

This retrospective observational study was conducted at a tertiary level III trauma center. Adult patients (> 18 years) with unilateral SER ankle fractures, a minimum follow-up of 1 year, no persistent symptoms, and fixation using a 1/3 tubular 3.5-mm locking plate (lateral or posterolateral) were included. Exclusion criteria comprised bilateral injuries, Weber A/C fractures, pathological fractures, previous ankle disorders, infection, postoperative pain, or functional limitations. The primary outcomes were peroneal tendon thickness on ultrasonography and functional performance assessed using the AOFAS Ankle-Hindfoot Scale. Outcomes were compared between fixation techniques.

Results

Seventy-six patients were included (65.8% aged 35–64 years, 60.5% women, 53.9% left-sided injuries). In most cases (71.1%), tendon thickness was greater on the operated side. Posterolateral plating demonstrated a higher frequency of positive tendon-thickness differences. Most differences measured 0–2 mm (56.6%), with a statistically significant difference between lateral and posterolateral fixation groups (p < 0.001). AOFAS scores were high in both groups, indicating satisfactory postoperative functional outcomes.

Conclusions

A difference in peroneal tendon thickness between the operated and contralateral sides was observed in 89.5% of patients, and these differences were significantly greater after posterolateral plating. Although plate position directly influenced postoperative tendon thickness, no clinically relevant consequences were identified.

Level of evidence

Level III.