ankle fracture

Question 1

complications of ankle fracture

Answer 1

Question 2

ottawa rules for ankle fracture

Answer 2

XR needed if:
* bony tenderness at the lateral malleolar zone
* bony tenderness at the medial malleolar zone
* inability to walk four weight bearing steps immediately and in ED

Question 3

what is the classification for ankle fractures

Answer 3

Weber

Question 4

Weber classification for ankle fractures

Answer 4

• Type A is below the syndesmosis
• Type B fractures start at the level of the tibial plafond and may extend proximally to involve the syndesmosis
• Type C is above the syndesmosis which may itself be damaged

A subtype known as a Maisonneuve fracture may occur with spiral fibular fracture that leads to disruption of the syndesmosis with widening of the ankle joint, surgery is required.

Question 5

Answer 5

weber type B ankle fracture

Question 6

Answer 6

weber type C ankle fracture

Question 7

Answer 7

weber type A ankle fracture

Question 8

mx of ankle fractures

Answer 8

1. immediately reduced - remove pressure on skin -> necrosis
2. open fracture -> emergency surgery within 24 hrs - internal fixation
3. closed fracture and dislocation -> closed reduction and splint

• young pts, high velocity prox injuries -> surgical repair (compression plate)
• elderly -> conservative mx

Question 9

mx of isolated medial malleolar fracture

Answer 9

• non-displaced - short leg cast 6wks
• displaced - internal fixation

Question 10

mx of bimalleolar/trimalleolar fracture

Answer 10

short leg cast / internal fixation

if displaced - internal fixation

Question 11

rf for ankle fracture

Answer 11

Question 12

signs and sx for ankle fracture

Answer 12

Question 13

XR for ankle fracture

Answer 13

• lateral
• stress view / standing anteroposterior
• mortise view - 15 degrees internal rotation of ankle

Question 14

mx of isolated lateral malleolar fracture

Answer 14

short leg cast / internal fixation
if displaced and irreducible - internal fixation