ANKLE FRACTURES AND FRACTUREDISLOCATION Fractures and fracturedislocation of

ANKLE FRACTURES AND FRACTUREDISLOCATION. • Fractures and fracture-dislocation of the ankle are common. • Mechanisms ; twisting slipping. • The injury may be caused by direct trauma.

CLASSIFICATION. • Fractures of the ankle can be classified according to ; v Mechanism of injury. The Lauge-Hansen classification. This classification is very complex. v Anatomical. The relation of the fracture of the fibula to the syndesmosis ; Weber A , Weber B and Weber C.

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.

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.

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.

COMPLICATIONS. • EARLY ; v. Skin breakdown esp. In fracture-dislocation. v. Vascular damage. v. Swelling plus blisters.

COMPLICATIONS ……. . • Late ; Ø Malunion. Ø Non-union. Ø Joint stiffness. Ø Osteo-arthritis. Ø Complex regional pain syndrome. d THE END.