Highlights & Basics
- Ankle fractures are commonly a low-energy fracture of either the lateral or medial malleolus, or both, and can include a fracture of the posterior malleolus.
- Vascular compromise is rare and is usually the result of fracture-dislocations.
- Proper immobilization, analgesia, and timely orthopedic referral as appropriate can greatly enhance patient comfort and ensure optimal outcome. Some nondisplaced or anatomically reduced ankle fractures can be treated conservatively, but consult with an orthopedist is generally recommended.
- Displaced fractures are commonly treated with an open reduction and internal fixation.
- Open fractures require emergency treatment by experienced surgeons including saline irrigation, wound debridement, and removal of all devitalized tissue and foreign debris.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Backslab application: Webril is applied usually overlapping by about 50% to give at least 2 layers of padding under the plaster
Backslab application: the plaster slabs are then applied (2 side supports that wrap around the foot and one posterior support)
Backslab application: an optional layer of Webril over the plaster prevents the tensor bandage or flannel from sticking and allows for ease of removal. The tensor bandage is then applied (some use flannel wrap) with minimal to no tension; it is "just rolled on"
Mortise view of a trimalleolar fracture dislocation with concomitant disruption of the syndesmosis
Mortise view of a trimalleolar fracture after fixation. Note: 2 syndesmosis screws were also used
Lateral view of a trimalleolar fracture after fixation
Citations
British Orthopaedic Association Standards for Trauma. The management of ankle fractures. Aug 2016 [internet publication].[Full Text]
American College of Radiology. ACR appropriateness criteria: acute trauma to the ankle. 2020 [internet publication].[Full Text]
American Academy of Orthopedic Surgeons. Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline. Mar 2022 [internet publication].[Full Text]
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7. British Orthopaedic Association Standards for Trauma. The management of ankle fractures. Aug 2016 [internet publication].[Full Text]
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