deltoid ligaments fibula medial malleolus posterior malleolus
TRANSCRIPT
Ankle fracture
Anatomy
Deltoid Ligaments
Fibula
Medial malleolus
Posterior malleolus
Clinical presentation
1. Deformity
2. Swelling
3. Bruises
4. Antalgic gait
Imaging
1. Radiographs- External rotation stress radiograph
Clear space >5mm
2. AP view - Lateral view - Oblique view
Classification
Lauge-Hansen Supination adduction Supination – external rotation Pronation – aduction Pronation – external rotation
Supination aduction
Supination lateral rotation
Pronation adduction
Pronation external rotation
Denis-Weber
A B C
Lateral malleolar
Treatment
Non-operative - short-leg walking cast/boot - <3mm displacement - <25% pasterior malleolar fracture- <2mm step-off
Operative treatment
O.R.I.F- Anatomic reduction
Medial malleolus
Non-displaced plaster
Medial malleolus
Displaced
O.R.I.F
Lateral malleolus
3mm displaced
O.R.I.F