Ankle fracture

Anatomy

Deltoid Ligaments

Fibula

Medial malleolus

Posterior malleolus

Clinical presentation

1. Deformity

2. Swelling

3. Bruises

4. Antalgic gait

Imaging

1. Radiographs- External rotation stress radiograph

Clear space >5mm

2. AP view - Lateral view - Oblique view

Classification

Lauge-Hansen Supination adduction Supination – external rotation Pronation – aduction Pronation – external rotation

Supination aduction

Supination lateral rotation

Pronation adduction

Pronation external rotation

Denis-Weber

A B C

Lateral malleolar

Treatment

Non-operative - short-leg walking cast/boot - <3mm displacement - <25% pasterior malleolar fracture- <2mm step-off

Operative treatment

O.R.I.F- Anatomic reduction

Medial malleolus

Non-displaced plaster

Medial malleolus

Displaced

O.R.I.F

Lateral malleolus

3mm displaced

O.R.I.F