Ankle Fracture

Question 1

Patterns

Answer 1

Isol medial or lat mall- transv frac suugs pushed off, oblique pulled. 
Bimalleolar
Posterior malleolus
Bosworth fracture dislocs
Open frac
Associated syndesmotic inj
Isolated syndesmotic inj
Pilon- comminuted distal tibia extending into ankle jnt. Large force drives talus up.

Question 2

Imp anatomy

Answer 2

Deltoid lig resists anterolat talar displ

Fibula acts as buttress to prev lat displ talus

Question 3

Weber classification

Location of fibular frac

Answer 3

A- infrasyndesmotic, not usually unstable. Often assoc avulsion. NO surg, cast 6wk.
B- transsyndesmotic. Frac starts at jnt lev and extends prox and oblique. Unstable if also medial mall or deltoid lig break. MAYBE surg
C- suprasyndesmotic. Us syndesmotic inj too. Somet medial mall and deltoid break. LIKELY surg

Question 4

Mx

Answer 4

-non op eg weber A non displ malleolar
Short leg ealking cast/boot.
-operative eg all weber C, somet B, somet displ A.
ORIF if displ, bimall, post mall, bosworth, open.

Question 5

Complics

Answer 5

-early-
Vasc inj
Wound breakd and infec
-late-
Incompl reduc
Non union
Stiffness
Algodystrophy
OA