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Published byVeronica Miles Modified over 9 years ago
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ANKLE FRACTURES AND FRACTURE- DISLOCATION. Fractures and fracture-dislocation of the ankle are common. Mechanisms ; twisting slipping. The injury may be caused by direct trauma.
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CLASSIFICATION. Fractures of the ankle can be classified according to ; Mechanism of injury. The Lauge-Hansen classification. This classification is very complex. Anatomical. The relation of the fracture of the fibula to the syndesmosis ; Weber A, Weber B and Weber C.
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CLINICAL FEATURES. History of twisting the ankle. Clinically the ankle is swollen, deformed ( if there is fracture-dislocation), and tender. Identify areas of tenderness because they are a clue to the diagnosis and treatment. Commonly closed injuries.
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INVESTIGATIONS. A fracture-dislocation of an ankle is a clinical diagnosis. The dislocation must be reduced and the ankle immobilized before sending patient to X-rays. You must request three X-rays ; AP, LATERAL AND OBLIQUE. Each X-ray film must include the ankle and knee joints.
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PRINCIPLES OF TREATMENT. Reduce fracture-dislocations urgently. Always splint the ankle. Elevate the ankle to decrease swelling. We operate all ankle fractures except those with a minimally displaced lateral malleolus with no medial tenderness. Fracture of an ankle unites in six weeks.
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COMPLICATIONS. EARLY ; Skin breakdown esp. In fracture-dislocation. Vascular damage. Swelling plus blisters.
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COMPLICATIONS …….. Late ; Malunion. Non-union. Joint stiffness. Osteo-arthritis. Complex regional pain syndrome. THE END.
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