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Emergency Med/Trauma > Ankle Fractures > Flashcards

Ankle Fractures Flashcards

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1
Q

Lauge-Hansen classification for ankles fractures is based on what 2 things?

A

Position of the foot

Motion of the talus

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2
Q

4 main patterns of the Lauge-Hansen classification

A 
Supination-AD
Pronation-AB
Supination-External
Pronation-External
-SAD, PAB, SER, PER
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3
Q

SAD stage 1

A
  • rupture of lateral collateral

- transverse fracture of fibula below AJ

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4
Q

SAD stage 2

A

Vertical fracture of the medial malleolus

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5
Q

Vertical fracture of the medial malleolus is pathognomonic for what type of fracture

A

Supination-ADduction ankle fracture

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6
Q

PAB stage 1

A
  • Rupture of the deltoid

- Transverse fracture of medial malleolus

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7
Q

PAB stage 2

A

Disruption of the AITFL and PITFL

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8
Q

PAB stage 3

A

Short oblique fracture of the fibula at the AJ

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9
Q

Explain the stages (4) of SER

A

1 - disruption of AITFL
2 - spiral fracture of the fibula
3 - Disruption of PITFL
4 - rupture of deltoid or transverse fracture of Med Mal

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10
Q

What is pathognomonic for supination-external rotation fracture?

A

Spiral fracture of the fibula at the AJ

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11
Q

Explain the stages (4) of PER ankle fractures

A

1- deltoid or transverse MM
2- AITFL or interosseous
3- Fibular fracture proximal to syndesmosis
4- Disruption of PITFL

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12
Q

What is pathognomonic for a pronation-external rotation ankle fracture?

A

High fibular fracture that is proximal to the syndesmosis

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13
Q

Explain where the fractures/issues with SAD/PAB/SER/PER begin, respectively

A

SAD - laterally
PAB - Medially
SER - Anteriorly
PER - Medially

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14
Q

The Danis-Weber classification of ankle fractures has how many main patterns? and is based on what relationship?

A

3 main patterns

Based on the fibula fracture and its relationship to the ankle joint

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15
Q

Danis-Weber A fx location

A

Fibular fracture below the level of the ankle

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16
Q

Danis-Weber B fx location

A

Fibular fracture at the level of the ankle

17
Q

Danis-Weber C fx location

A

Fibular fracture above the level of the ankle

18
Q

Danis-Weber A is equal to what Lauge Hansen?

A

Supination-Adduction

19
Q

Danis-Weber B is equal to what Lauge Hansen?

A

Supination-external rotation OR Pronation-abduction

20
Q

Danis-Weber C is equal to what Lauge Hansen?

A

Pronation-external rotation

21
Q

Medial clear space - what is it

A

Space between lateral aspect of medial malleolus and the medial aspect of the talar body

> 3-5 mm represents a deltoid tear

22
Q

Tibio-Fibular Overlap

A

Evaluate the syndesmosis

> 10 mm is normal

23
Q

Talar Tilt

A

Evaluates the lateral ligaments

> 15 degrees is a tear

24
Q

Tibio-Fibular Clear Space

A

Evaluates the syndesmosis and lateral talar shift

<5 mm is normal

25
Q

Avulsion fracture fixation options

A

Tension band wire
Cross K wires
Lag Screws that are partially threaded cancellous

26
Q

Vertical Medial Malleoulus fracture fixation options

A

Lag Screw using 2-3 partially threaded cancellous screws

27
Q

Spiral fracture fixation options

A

Interfragmentary compression screws

  • perpendicular to bone
  • perpendicular to fracture line

Plate

28
Q

Difference b/w Lag by Technique and Design

A

Technique –> cortical screw, guide hole, glide hole

Design –> cancellous screw, guide hole

29
Q

What does cancellous not need a glide hole?

A

Because it has a smoother portion to glide in

30
Q

Explain using a plate for a spiral fibular fracture

A

Neutralization plate

  • 1/3 tubular
  • cortical screws proximal
  • cancellous screws distal
31
Q

When inserting a cortical/cancellous screw through a plate, do you need to drill a guide hole, glide hole, or both?

A

Only a GUIDE hole

32
Q

Oblique Fibula or High Fibula fixation options

A

Need to use a plate b/c the fracture is too short to insert a interfragmentary screw

33
Q

When do you fixate a posterior malleolus fracture?

A

When it doesn’t reduce via Vassal’s

When it’s greater than 25% of the joint surface

34
Q

Explain the direct fixation for posterior malleolus fractures

A

Partially threaded cannulated screw directed P to A

35
Q

Explain the indirect fixation for posterior malleolus fractures

A

Partially threaded cannulated screw direct A to P

36
Q

Explain the technique for using a Syndesmotic screw

A

Insert screw proximal to the ankle, angle it anterior, dorsiflex the foot

37
Q

How do you use a cortical screw for syndesmotic repair

A

No lag technique

Engage all four cortices

38
Q

How do you use a cancellous screw for syndesmotic repair

A

Fully threaded and engage only 3 cortices

39
Q

Prior to WB, what do you do with the syndesmotic screw?

A

REMOVE

Emergency Med/Trauma (26 decks)

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