title: Incidence and Association of CT Findings of Ankle Tendon Injuries in Patients Presenting With Ankle and Hindfoot Fractures.
abstract: OBJECTIVE
  Tendon injuries are a commonly encountered finding in ankle CT examinations performed for fractures. This study was designed to identify the incidence and associations of tendon injuries in ankle CT examinations performed for fractures.
  
  
  METHODS
  A retrospective review was performed of 410 patients who underwent ankle CT during a 6-year period.
  
  
  RESULTS
  Tendon injuries were common, seen in 25% of all ankle CT examinations. Tendon subluxation-dislocation accounted for most of the tendon injuries (77 of 196 total injuries). Pilon fractures carried 2.2 times increased risk of tibialis posterior tendon injury (p = 0.0094). Calcaneus fractures carried 11.86 times increased risk of peroneus brevis tendon and 10.71 times increased risk of peroneus longus tendon injury (p < 0.0001). Calcaneus fractures also carried 5.21 times increased risk of flexor hallucis longus tendon injury (p = 0.0024). Talus fracture was associated with injury to all flexor compartment tendons. Talus fractures carried 3.43 times increased risk of tibialis posterior tendon injury (p < 0.0001), 4.51 times increased risk of flexor digitorum longus tendon injury (p = 0.0005), and 6.97 times increased risk of flexor hallucis longus tendon injury (p < 0.0001).
  
  
  CONCLUSIONS
  Calcaneal fractures are prone to peroneal tendon injury, and talus fractures are prone to flexor tendon injury. In patients with pilon fractures, it is important to look for tibialis posterior tendon injury, specifically for entrapment. Overall, the most common type of injury is tendon malalignment, so it is imperative to know the normal tendon paths and associated bony landmarks to identify tendon injury.
authors.affiliation: 1 Department of Radiology, The University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.116, Houston, TX 77030.
authors.forename: Ashkahn
authors.initials: A
authors.lastname: Golshani
authors.affiliation: 2 Biostatistics/Epidemiology/Research/Design Core, Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, Houston, TX.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhu
authors.affiliation: 2 Biostatistics/Epidemiology/Research/Design Core, Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, Houston, TX.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Cai
authors.affiliation: 1 Department of Radiology, The University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.116, Houston, TX 77030.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Beckmann
mesh_terms: D000328:Adult; D064386:Ankle Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005529:Foot Bones / Q000000981:diagnostic imaging / Q000293:injuries; D006801:Humans; D015994:Incidence; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013708:Tendon Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D013781:Texas / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
keywords: ankle fracture; ankle tendon injury; hindfoot fracture; peroneal tendon injury; tendon injury