Deltoid Ligaments Fibula Medial malleolus Posterior malleolus.

Ankle fracture

Anatomy

Deltoid Ligaments

Fibula

Medial malleolus

Posterior malleolus

Clinical presentation

1. Deformity

2. Swelling

3. Bruises

4. Antalgic gait

Imaging

1. Radiographs- External rotation stress radiograph

Clear space >5mm

2. AP view - Lateral view - Oblique view

Classification

Lauge-Hansen Supination adduction Supination – external rotation Pronation – aduction Pronation – external rotation

Supination aduction

Supination lateral rotation

Pronation adduction

Pronation external rotation

Denis-Weber

A B C

Lateral malleolar

Treatment

Non-operative - short-leg walking cast/boot - <3mm displacement - <25% pasterior malleolar fracture- <2mm step-off

Operative treatment

O.R.I.F- Anatomic reduction

Medial malleolus

Non-displaced plaster

Medial malleolus

Displaced

O.R.I.F

Lateral malleolus

3mm displaced

O.R.I.F