Bones: tibia, fibula, talus
Mortise joint: tibial plafond, fibula above (forming medial and lateral malleolus) and talus below
Ligaments: syndesmotic, lateral collateral, and medial collateral (d...
Location of pain, timing, and mechanism of injury (key historical element is exact mechanism)
Weight-bearing status after injury
History of ankle injury or surgery
Tetanus status
Assess f...
Immobilize in temporary cast/splint and protect with crutches/non–weight-bearing.
1 to 2 weeks to allow decreased swelling, if not open or irreducible fracture
Ice and elevate ...
Orthopedic follow-up: serial x-rays
In children, sclerotic lines on x-ray (Parker-Harris growth arrest lines) indicate growth disturbance.
Immobil...
S82.899A Oth fracture of unsp lower leg, init for clos fx
S82.899B Oth fracture of unsp lower leg, init for opn fx type I/2
S82.56XA Nondisp fx of medial malleolus of unsp tibia, init
S82.66XA...
OAR are nearly 100% sensitive in determining the need for x-rays.
Assess neurovascular status, ability to bear weight, and associated injuries.
Assess joint above/below to avoid overlook...
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FIGURE 33-2. Bimalleolar ankle fractures: open reduction and internal fixation. A: The anteroposterior radiograph demonstrates an isolated fibula fracture. B: A stress view, taken with external rotation of the foot with the ankle in dorsiflexion, documents medial clear space widening and talar shift.
FIGURE 33-2. Bimalleolar ankle fractures: open reduction and internal fixation. A: The anteroposterior radiograph demonstrates an isolate...
FIGURE 33-26. Bimalleolar ankle fractures: open reduction and internal fixation. A and B: Stabilization of the posterior malleolus using two cancellous screws directed from posterior to anterior aspects.
FIGURE 33-26. Bimalleolar ankle fractures: open reduction and internal fixation. A and B: Stabilization of the posterior malleolus using ...
FIGURE 33-27. Bimalleolar ankle fractures: open reduction and internal fixation. Final intraoperative anteroposterior (A), mortise (B), and lateral (C) radio
FIGURE 33-27. Bimalleolar ankle fractures: open reduction and internal fixation. Final intraoperative anteroposterior (A), mortise (B), a...
FIGURE 47-7. (continued) Anteroposterior (B) and lateral (C) radiographs show an unstable supination-external rotation stage IV ankle fracture with the characteristic oblique distal fibula fracture and a medial side injury. D: An anteroposterior radiograph of a supination-adduction ankle fracture with a transverse fibula fracture and an impacted medial malleolar fracture.
FIGURE 47-7. (continued) Anteroposterior (B) and lateral (C) radiographs show an unstable supination-external rotation stage IV ankle fra...
FIGURE 47-9. Schematic diagram and case examples of the AO/OTA classification of ankle fractures. A: There are three types of ankle fractures in the AO/OTA classification: type A, type B, and type C. Each type is further subdivided into three groups. B: An anteroposterior radiograph of a type A distal fibula fracture in which the fracture line is completely below the level of the syndesmosis. C: A radiograph of a type B ankle fracture in which the fibula fracture begins anteriorly at the l...
FIGURE 47-9. Schematic diagram and case examples of the AO/OTA classification of ankle fractures. A: There are three types of ankle fract...
FIG. 22.37. A radiograph of the left ankle of a 10-year-old boy notable only for soft-tissue swelling localized to the distal fibula (arrows). If the patient is tender over the growth plate, the presumptive diagnosis is a Salter-Harris type I injury.
FIG. 22.37. A radiograph of the left ankle of a 10-year-old boy notable only for soft-tissue swelling localized to the distal fibula (arro...