Lower leg fractures? Flashcards
What is a tibial fracture?
Most common fracture
Open fractures common due to SC position
Must ensure both knee and ankle is imaged
What is the management of a tibial fracture?
Minimally/undisplaced them full length cast
Displaced= reduction under GA with XR guidance and then cast
Limb elevated for 48hrs to look for compartment syndrome
Repeat XR 2wks later to check position
At 4wks cast changed to below knee to allow weight bearing
What are ankle fractures?
Common injury in young athletes or older osteoporotic women
3 malleoli can be fractured
- medial
- lateral
- posterior (formed by posterior tibia)
Most common mechanism is abduction and lateral rotation of joint causing lateral malleolus to be sheared off
What is found on examination for a patient with ankle fracture?
Intense pain and inability to stand
What is weber Classification?
Used to classify lateral malleolus fractures based on tibifibular joint (syndesmosis)
A- fracture below syndesmosis
B- fracture at level of syndesmosis
C- fracture above syndesmosis
What is talar shift?
Important indicator of instability in the ankle
If talus no long exhibits equal joint space around its articulation with tibia and fibula then likely to need surgery
What is the management of ankle fractures?
Weber A
-6 weeks of plaster normally works
Weber B
-Conservative management with repeat XR at wks 1, 2 and sometimes 3
Weber C
- Never stable
- requires open reduction and internal fixation
If >1 malleoli is unstable= surgery
What is ottowa rules for ankle fractures?
XR of ankle is only required if patient is unable to weight bare, has pain and bony tenderness over lateral or medial malleolus
XR of foot is only if unable to weight bare and bony tenderness over navicular/base of 5th metatarsal
