Ankle Fracture

Question 1

ESSENCE

Answer 1

Fracture of the lateral malleolus (distal fibula) or medial malleolus (distal tibia)

Question 2

What defines fractures of lateral malleolus (distal fibula)

Answer 2

• Weber’s classification
  
  • A - below tibiofibular syndesmosis, leaving it intact
  • B - level of syndesmosis, leaving it intact or partially torn
  • C - above syndesmosis, leaving it disrupted

Question 3

CLINICAL FEATURES

Presentation

Answer 3

• Ankle pain and swelling
• Inability to weight bear
• Medial and/or lateral malleolus swollen and tender to palpation
• Pop heard on fall
• Ankle deformity

Question 4

AETIOLOGY

Risk factors

Answer 4

• Osteoporosis
• Falls
• Low-energy fall
• Inversion injury to ankle
• Playing sports

Question 5

AETIOLOGY

Pathophysiology

Answer 5

• Usually from rotary force as oppose to axial force

Question 6

AETIOLOGY

Most common cause

Answer 6

Low energy fall

Question 7

MANAGEMENT

General principles

Answer 7

• If open, emergency surgery
• If closed, closed reduction and splint

Question 8

MANAGEMENT

Lines for initial closed fracture and dislocation

Answer 8

• 1) Closed reduction and splint
• 2) Open reduction and fixation

Question 9

MANAGEMENT

Lines for acute management

Answer 9

• Non-displaced
  
  • 1) Short leg cast
• Displaced
  
  • 1) Internal fixation