Ankle Fracture

Question 1

What are the Ottowa ankle fracture rules?

Meeting these rules means what?

Answer 1

PAIN in the MALLEOLUS AREA
(+1 of…)
a. bony tenderness in the medial malleolus
b. bony tenderness in the lateral malleolus
c. inability to weight bear immediately afterward and in ED

Xray needed

Question 2

Explain the Weber classification

Answer 2

Weber A - below the syndesmosis
Weber B - level of syndesmosis
Weber C - above syndesmosis

Question 3

What is the syndesmosis?

Answer 3

The unmovable joint where the tibia and fibula meet

Question 4

How are ankle fractures managed?

Answer 4

POP (plaster of paris) immobilisation if unstable

Weber A, undisplaced and stable = CAM boot

If displaced ORIF - sometimes this is the case
- esp if Weber C with spiral fracture

Question 5

What is the most important first step if displaced?

Answer 5

Reduce immediately to reduce risk of damage to the skin

Question 6

Is a patient allowed to weight bear in a Weber A minimally displaced fracture?

Answer 6

Yes - in a CAM boot (like the type Alex wears)

As much as patient can tolerate