Abstract：Objective To evaluate the radiological features of the Logsplitter injury in high energy ankle fractures and the pathological features of the anatomical structures around the ankle joint. To explore the mechanism of Logsplitter injury.Methods Retrospective analysis of 62 cases of Logsplitter lesions admitted to the Red Cross Hospital affiliated to Xi'an Jiaotong University from April 2009 to December 2018. There were 44 males and 18 females, aged 21-69 (42.3±11.7) years, 27 cases on the left side and 35 cases on the right side. The characteristics of fibula injury, tibia injury, syndesmosis injury, medial injury and lateral ligament injury in the preoperative X-ray and CT scans were analyzed. The incidence of different injury types was summarized. According to the Lauge-Hansen classification of ankle fractures, the correlation between Logsplitter injuries and different types of mechanicals were analyzed.Results The fibula injuries without fracture (1.6%, 1/62), transverse or short oblique fractures (61.3%, 38/62), and butterfly fragments (25.8%, 16/62) and comminuted fractures (11.3%, 7/62). The tibial injuries included compression of lateral articular surfaces (38.7%, 24/62) and posterior compressions (6.5%, 4/62). Medial injuries including medial malleolus fractures accounted for 87.1%(54/62), deltoid ligament rupture accounted for 12.9%(8/62). The injuries of syndesmosis included simple ligament ruptures (11.3%, 7/62), combined with Tillux fractures (8.1%, 5/62), combined with Volkmann fractures (43.5%, 27/62), combined with Tillux and Volkmann fractures (37.1%, 23/62). Complete rupture of lateral collateral ligament was found in 12.9%(8/62) cases. According to Lauge-Hansen classification, 87.1%(54/62) were pronation-abduction injuries. And 8.1%(5/62) were pronation and external rotation injuries. And 1.6%(1/62) was supination external rotation injuries. And 3.2%(2/62) could not be classified.Conclusions The pathoanatomic features of Logsplitter injury are diversified. In the case of severe fracture and dislocation, the collateral ligament injury can be combined. The vertical violence is the most common injury mechanism, however, in some cases; the mechanism may be the vertical combined external-rotation injury.
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2020, Vol. 25 
