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Ankle Fracture/Dislocation, Emergency Medicine

Reviewed 06/2017



Common mechanisms and injury patterns of the ankle: 
  • Mechanism of injury:

    • Inversion injury: Lateral ankle distraction and medial ankle compression

      • Avulsion fracture of the lateral malle...


Signs and Symptoms

  • History of trauma

  • Local ankle pain, swelling, deformity

  • Inability to bear weight

  • Soft tissue injury, swelling, ecchymosis, skin tenting, skin blanching

  • Neurovascular compromise...



  • Immobilize with soft splint to reduce pain, bleeding, and further injury

  • Cautions:

    • Traction devices are usually unnecessary:

      • Contraindicated with open injuries

    • Protruding bone should...



Admission Criteria

  • Unstable ankle fractures require urgent orthopedic consultation and may require admission

  • Open ankle fractures and dislocations should be admitted for debridement...

Pearls and Pitfalls

  • To reduce a dislocated ankle, partial flexion of knee of affected limb will decrease tension on Achilles tendon and ankle

  • Differentiate between ankle fracture and subtalar fracture ...

Additional Reading

  • Bachmann  LM. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. Br Med J.  2003;326:417.

  • Blackburn,  EW, Aronsson  DD, Rubright  ...



  • 824.0 Fracture of medial malleolus, closed

  • 824.8 Unspecified fracture of ankle, closed

  • 824.9 Unspecified fracture of ankle, open

  • 824.2 Fracture of lateral malleolus, closed

  • 824.1 Fracture of med...

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