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Fracture, Volkmann (Posterolateral Malleolus), Sports Medicine

Holly J. Benjamin, MD, FAAP, FACSM and David J. Pohl, DO Reviewed 04/2019
 


BASICS

Pediatric Considerations
  • Volkmann fracture is a rare injury in children <14 yr of age, given the relative weak physis of the tibia.

  • Salter-Harris fractures occur during external rotation and a...

DIAGNOSIS

HISTORY

  • Ankle injury involving a Volkmann fracture is rarely subtle, given typical concomitant fractures and ligament tears.

  • A mechanism of injury involving a significant external rotation or ...

TREATMENT

GENERAL MEASURES

  • Closed reduction is generally not indicated prior to definitive treatment, unless the neurovascular structures or skin are compromised.

  • If compromised, reduction of dislocatio...

ONGOING CARE

PROGNOSIS

  • Posterior tubercle fractures adversely affect the prognosis of ankle fractures compared to single or bimalleolar fractures 1[C],4[A],6[B].

  • Although often used as an indication for...

REFERENCES

1
Irwin TA, Lien J, Kadakia AR. Posterior malleolus fracture. J Am Acad Orthop Surg.  2013;21(1):32–40.
2
Haraguchi N, Haruyama H, Toga H, et al. Pathoanatomy of posterior malleolar fract...

ADDITIONAL READING

  • Clare MP. A rational approach to ankle fractures. Foot Ankle Clin.  2008;13(4):593–610.

  • Donken CC, Goorden AJ, Verhofstad MH, et al. The outcome at 20 years of conservatively tr...

CLINICAL PEARLS

  • Volkmann fractures are avulsion fractures of the posterior lip of the tibia at its articular surface via a significant external rotation or abduction force through the PITFL.

  • Lateral an...

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