4b. Ankles Flashcards
what is the mechanism of injury for a calcaneofibular ligament tear
inversion and eversion
what happens when the ankle is inverted
fracture the calcaneofibular ligament and avulse the distal end of the lateral malleolus
can also avulse both malleoli
what happens when the ankle is everted
can # medial malleolus and can rupture syndesmosis and intraosseous membrane or higher up on the tibia
what are the soft tissue sign of ankle injuries
effusion/blood in joint and will get raising of fat pad and seen best in front
dark area in triangle of space where Achilles tendon is
what are the 3 types of malleoli fractures
uni/bi/trimalleolar
what is a uni malleolar fracture
only one malleolus is fractured
what is a bimalleolar fracture
both the medial and lateral malleoli are fractured
what is a trimalleolar fracture
med/lat malleoli fracture and posterior part of tibia
what is a webers A injury
Weber A is decided upon where the # is on the fibula or lateral malleolus, if its very low down below the syndesmosis - could be bi malleolar
what is a webers B injury
B is almost always spiral # and goes through syndesmosis
what is a webers C injury
C is higher up fibular and through interosseous memb and through syndesmosis and med malleolus
which webers classification is most unstable
C
what is a gravity stress view used for
checking for movement of talus laterally to show ligamentous rupture - deltoid ligament
why are gravity stress views useful
If talus hasn’t moved but looks like it has moved a tiny bit it can be proved by putting gentle stress on distal part and widens the gap and can see that the ligament has been compromised may not be completely ruptured
what is a maisonneuve fracture
high weber C fracture
what does a maisonneuve fracture look like on an image
Interosseous membrane and syndesmosis tears and results in widened joint spaces
Angle that looks like its subluxed and widened joint space but no obvious fracture but as it’s a ring structure, there must be another injury
what is os trigonum
small extra bone that sits at the back of the ankle joint as the ossification centre hasnt fused so looks like fracture
what is osteochondritis dissecans of the talus and why does it occur
Vascular injury
Occurs when athletic people has stress injury and eventually the little divet becomes fractured and there is no blood supply to it and will flake away and cause loose body in joint
joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow
what are the signs of osteochondritis dissecans of the talus on an image
osteochondral lesion with/without detachment and on a side of the talar dome
what is brodies abscess
sub acute infection
where is the brodies abscess commonly found
metaphysis
what does osteomyelitis look like on an xray
infection in bone turns everything to pus and mush
what are the 4 signs of OA
narrowed joint space
sclerotic margin
osteophytes
subchondral cysts
what is talo calcaneal coalition
calcaneus and talas have not separated in formation when child was made
