T&O: Ankle Fractures Flashcards

1
Q

What classification system is used in ankle fractures?

A

Weber classification: based on the fibular fracture in relation to the tibiofibular syndesmosis.

Type A, B and C.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the features and management of a Weber A fracture.

A

Features:

  • fibular fracture distal to tibiofibular syndesmosis
  • syndesmosis intact
  • deltoid ligament intact
  • medial malleolus occasionally fractured

Management:

  • usually stable
  • can often be managed conservatively, e.g. POP cast.
  • sometimes requires open reduction and internal fixation, esp. if medial malleolus fractured
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the features and management of a Weber B fracture.

A

Features:

  • fibular fracture level to syndesmosis, or only partially torn
  • deltoid ligament may be torn
  • medial malleolus may be fractured

Management:

  • variable stability
  • likely requires ORIF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the features and management of a Weber C fracture.

A

Features:

  • fibular fracture proximal to syndesmosis
  • tibiofibular syndesmosis disrupted, with widening of distal tibiofibular articulation
  • medial malleolus fracture or deltoid ligament injury present

Management:

  • unstable
  • requires ORIF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a trimalleolar fracture?

A

Fracture of:

  • lateral malleolus
  • medial malleolus
  • posterior corner of tibia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a Maisonneuve fracture?

A

Combination of:

  1. spiral fracture off proximal fibula
  2. unstable ankle injury - can manifest radiologically by:
    - widening of ankle joint due to distal tibiofibular syndesmosis and/or fdeltoid ligament disruption OR
    - fracture of medial malleolus

Is caused by pronation external-rotation mechanism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Should Pts with stable Weber A fractures be allowed to weight bear? Why?

A

Yes. The fracture is stable as the intact deltoid ligament maintains the position of the talo-tibial joint. Weight bearing actually improves healing of the fibular fracture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can an ankle fracture be identified as stable on x-ray?

A

Look at medial side of joint: when undisplaced there is a medial clear space of <5 mm. Displaced/unstable if >5 mm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many ankle fractures are stable? How would you manage these?

A

70%

No active treatment necessary

  • RICE
  • ankle brace
  • full weight-bearing
  • active exercise
  • no check x-rays
How well did you know this?
1
Not at all
2
3
4
5
Perfectly