deltoid ligaments fibula medial malleolus posterior malleolus
Post on 24-Dec-2015
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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
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