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PodMed > Ankle Fractures (Pod med) > Flashcards

Ankle Fractures (Pod med) Flashcards

1
Q

Remember these structures

A
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2
Q

Remember these structurez

A
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3
Q

The OTTAWA ankle rules:

If pain exist in A

PLUS one or more of the following:

B

C

D

A

A : near one or both of the malleoli

B: Age < 55 years old

C: Inability to weight bear

D: Bone tenderness over the the posterior edge or tip of either malleolus

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4
Q

What is the normal space for Tib-Fib clear space on the mortise view?

A

less than 5 mm

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5
Q

What is Mortise x-ray view?

With the A in B degrees of C rotation

Mortise view is useful in valuation of articular surface

between D and E

A

A: Ankle

B: 15-25 degrees

C: Internal rotation

D: Talar dome

E: Mortise

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6
Q

Where is the Medial Clear space?

What is the normal value?

A

Medial clear space is between

Lateral border of medial malleous

and

Medial Talus

The normal value is less than 4 mm

And more than 4mm suggest lateral shift of talus

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7
Q

Fibular fracture above the level of the ankle joint indicates

that the A is torn.

A

A: Distal anterior tibiofibular ligament

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8
Q

Fracture of fibula above its anterior tubrcle strongly suggests that the B is completely distrupted.

A

​B: Tibiofibular syndosmosis

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9
Q

Fracture of fibula above the level of ankle joint WITHOUT accompaying fracture of the medial malleolus indicates rupture of A

A

A deltoid ligament

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10
Q

A fracture of the medial malleolus indicates that the deltoid ligament is intact

A

A Transverse

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11
Q

What is Maison neuve fracture?

A

High fracture of the fibula

fracture of the medial malleolous

Tear of tibiofibular ligament

Rupture of interoseous membrane

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12
Q

What does the inversion stress view shows?

A

This angle helps to diagnose tears of lateral collateral ligament.

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13
Q

The anterior-draw stress film provides a useful measurment for determining injury to the

A ligament

A

A : anterior talofibular ligament

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14
Q

Values of upto A of seperation between the talus and distal tibia are considered normal

Values between B and C may be normal or abnormal and the opposite ankle should be tested

Values above D are always abnormal

A

A: 5mm

B: 5mm and C: 10mm

D: 10mm

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15
Q

What are the primary goals for management of ankle fractures?

A
  • Restore function
  • Return to normal function
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16
Q

What are different types of fractures?

Hint: 8 different

A
  1. Spiral
  2. Oblique
  3. Transverse
  4. Comminuted
  5. Wedge
  6. Impacted/Compression
  7. Displaced
  8. Open or compound
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17
Q

Supination Adduction

It occurs in A% of ankle fractures

The foot is fixed on the ground in B position with an C force is applied to the talus

A

A: 20-25%

B: Supination C: Adduction

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18
Q

Suppination Adduction

Stage 1

Supination results in a tear of the A ligament

or

An B fracture of the C below the level of tibial plafond

A

A: Lateral collateral ligament

B: avulsion

C: Lateral malleolus

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19
Q

Supination Adduction

Stage 1

A rupture with or without B fragment and or C fracture of D malleoli below the ankle mortise

A

A: lateral ligament

B: Avulsion

C: transverse

D: lateral

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20
Q

Supination Adduction

Stage 2

A fracture of the B malleoli

A

A: Vertical

B: Medial

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21
Q

Supination Adduction

Stage 2

More talar tilt results in the medial malleolus being

pushed of in a A or B way

A

A: Vertical

B: Oblique

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22
Q

What is the name of this fracture?

A

Supination Adduction

23
Q

What does the grey arrow show?

What does the orange arrow show?

A

Grey arrow: Lateral injury, transverse fibular fracture below or at the level of mortise

Orange arrow: Medial injury, vertical shear type, medial malleolar fracture

24
Q

Pronation- Abduction

It occurs very A

Stage 1: B medial C fracture

Or D ligament rupture

A

A: Rarely

B: Transverse C: Malleoli

D: Deltoid

25
Q

Pronation Abduction

Stage 2: As the abductory force continues to push the talus A

Creating injury to both B and C

In this stage the D is still intact

A

Pronation Abduction

A: Laterally

B: Anterior tibiofibular

C: Posterior tibiofibular

D: interossious ligament

26
Q

Pronation Abduction

Stage 3: In this stage the abductory force has continued into the fibula creating a fracture at A

that is B on AP view

But appears C on a lateral view

A

Pronation Abduction

A: at or above the ankle joint

B: short and oblique

C: transverse

27
Q

Pronation Abduction

Stage 3: A fracture typically proximal to mortise

often with a B fragment

The lateral view is important to differentiate it from

C fracture

A

Pronation Abduction

A: Fibula

B: Butterfly

C: Supination Eversion

28
Q

Supination External rotation

This is the A common fracture

In stage 1:

Rupture of B ligament

Or a fracture of C, also known as D

A

Supination External rotation

A: Most common

B: Anterior tibiofibular ligament

C: Lateral distal tibia

D: Tillaux- Chaput fracture

29
Q

Supination External Rotation

Stage 2: Spiral fracture of A at the B level

The most commonly encountered ankle fracture

A

Supination External Rotation

A: Fibula

B: Syndosmotic level

30
Q

Supination- External Rotation

Stage 3: As the force progresses it will involve either a rupture of A

Or the fracture of B of the tibia

Also known as the C fracture

A

Supination- External Rotation

A: Posterior tibiofibular ligament

B: Posterior Malleolus of the tibia

C: Volkman’s fracture

31
Q

Supination External rotation

Stage 4: A ligament tear or B transverse fracture

A

A: Deltoid B: Medial Malleolus

32
Q

Supination- External Rotation

Hallmarks of this injury:

Injury begining at the A aspect of the fibula

A

A: Lateral

33
Q

Pronation External rotation

With the foot in a fixed pronated position, the force

starts along the A aspect of the tibia

Stage 1: Rupture of B ligament

or transverse fracture of C

A

A: Medial

B: Deltoid

C: Medial Malleolus

34
Q

Pronation external rotation

As the injury progresses forward to stage 2, the talus rotates further laterally putting tension on the A ligament resulting in either rupture of this ligament or an avlusion fracture of B Also known as C fracture

A

A: Anterior inferior tibiofibular ligament

B: anterior portion of fibula or tibia

C: Volkman’s fracture

35
Q

Pronation External rotation

As the force continue pass stage 2,

Rupture of A memabrane begin to occur distally at the level of B

A

A: Intersous membrane

B: Ankle joint

36
Q

Pronation External Rotation

Stage 3 fracture

High A fracture with B

This fracture can be at various levels of fibula

A

A: Fibular fracture

B: Interosseus membrane

37
Q

Pronation External rotation

If the forces progress into stage 4

either a rupture of A

or a fracture of B also know as C occurs

True diastasis fracture

A

A: posterior tibiofibular

B: Posterior malleoules

C: Volkman fracture

38
Q

Pronation External Rotation

The main hallmark is the A

A

A: High fracture of the fibula

39
Q

What stage and type of injury has occured?

A.

B.

A

A. Stage 4

B. Pronation External rotation

because the fracture has occured proximally

40
Q

Exam

Weber Classification

Weber A

Weber B

Weber C

Concept!

A

A: Fibula distal to mortise

B. Fibula at level of mortise

C: Fibula proximal to mortise

The higher the the fibula the more severe the injury

41
Q

Maionneure fracture:

Fracture of A with B disruption

A

A: Proximal fibula

B: Syndesmotic disruption

42
Q

Volkman Fracture

Fracture of A attachment of B

C fracture type

A

A: tibial attachment

B: PITFL

C: Posterior Malleolar fracture

43
Q

Tillaux- Chaput fracture

Fracture of tibial attachment of A

A

A: AITFL

44
Q

Pott fracture

In Pott fracture,

the fibual is fractured above A

The B is ruptured

The C is laterally subluxed

A

A: the intact distal tibiofibular syndesmosis

B: Deltoid

C: Talus

45
Q

Dupuytern fracture

This fracture usually occurs A above the B

With disruption of the C ligament

and Typically tear of the D leading to ankle instability

A

A: 2 to 7 cm

B: dital tibiofibualr syndesmosis

C: Medial collateral ligament

D: syndosmosis

46
Q

Wagstaffe-Lefort fracture

In this fracture, the medial portion of the A is avulsed

at the insertion of the B

the C however, remains intact

A

A: Fibula

B: anterior tibiofibular ligament

C: ligament

47
Q

Bosworth fracture dislocation

A fracture with posterior dislocation of B segment behind tibia

A

A: Fibular fracture

B: Proximal fibular

48
Q

The terms A, B, and C all have been used to intraarticular fractures of the distal tibia.

A

A: tibial plafond fracture

B: Pilon fracture

C: Disal tibial explosion fracture

49
Q

Classify this fracture

A

Supination abduction (external rotation)

stage 4

50
Q

Classify this fracture?

A

Pronation abduction

stage 3

51
Q

What are the 3 indications for non-operative short leg walking cast/boot?

    1. 3.
A
  1. Isolated nondisplaced medial malleolus fracture or tip avulsions
  2. Isolated lateral malleolus fracture with < 3mm displacement and no talar shift
  3. Posterior malleolus fracture with < 25% joint involvment
52
Q

EXAM

What are the 7 indications for Operative open reduction internal fixation?

            1. 7.
A
  1. Any talar displacement
  2. Displaced isolated medial malleolar fracture
  3. Displaced isolated lateral malleolar fracture
  4. Bimalleolar fracture and bimalleolar equivalent fracture
  5. Posterior malleolar fracture with > 25% involvment
  6. Bosworth fracture-dislocations
  7. Open fractures
    8.
53
Q
A

PodMed (29 decks)

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