Ankle Fractures

Question 1

Recommended radiographs for evaluating an ankle fracture (5)?

Answer 1

1. AP
2. Lateral
3. Mortise
4. External rotation stress view
5. Full-length tibia, or proximal tibia- r/o Maisonneuve type fracture

Question 2

Radiographic findings of a syndesmotic injury (3)?

Answer 2

1. Decreased tibiofibular overlap - at max overlap
   — < 6 mm on AP
   — < 1 mm on mortise
2. Increased tibiofibular clear space - measure 1 cm above joint
   — > 6 mm on AP and mortise
3. Increased medial clear space
   — > 5 mm on external rotation stress view - only one of the three that is predictive of deep injury

Question 3

Normal Ankle ROM (Dorsi and plantarflexion)

Answer 3

Dorsiflexion - 30 degrees

Plantarflexion - 45 degrees

Question 4

Ligaments that make up the ankle syndesmosis (4)

Answer 4

1. AITFL - anterior inferior talofibular ligament
2. PITFL - posterior inferior talofibular ligament
3. Inferior transverse talofibular ligament
4. Interosseous ligament

Question 5

Ligaments that make up the deltoid ligament (3 superficial and 2 deep)

Answer 5

Superficial

1. Naviculotibial ligament
2. Superficial talotibial ligament
3. Tibiocalcaneal ligament

Deep

1. Deep anterior talotibial ligament
2. Deep posterior talotibial ligament

Question 6

Lateral ligamentous complex of the ankle (3)

Answer 6

1. ATFL - Anterior talofibular ligament
2. PTFL - Posterior talofibular ligament
3. CFL - Calcaneofibular ligament