Paratrooper's ankle fracture: posterior malleolar fracture.
BACKGROUND
We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes.


METHODS
Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity.


RESULTS
The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome.


CONCLUSIONS
Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to undergo surgical repairs.
Surgery of Foot and Ankle, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea.
Ki Won
KW
Young
Surgery of Foot and Ankle, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea. ; Department of Orthopedic Surgery, Military Capital Hospital, Seongnam, Korea.
Jin-su
JS
Kim
Department of Orthopedic Surgery, Military Capital Hospital, Seongnam, Korea. ; Department of Orthopaedic Surgery, Inje University Seoul Paik Hospital, Seoul, Korea.
Jae Ho
JH
Cho
Surgery of Foot and Ankle, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea.
Hyung Seuk
HS
Kim
Surgery of Foot and Ankle, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea.
Hun Ki
HK
Cho
KT Lee's Foot and Ankle Clinic, Seoul, Korea.
Kyung Tai
KT
Lee
D000328:Adult; D064386:Ankle Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001359:Aviation; D001860:Bone Plates; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008889:Military Personnel; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult
Ankle injury; Fracture; Parachuting