• Emergency medicine physicians usually label ankle fractures according to the number of fractures in the ankle (unimalleolar, bimalleolar, trimalleolar). (medscape.com)
  • Isolated transverse or vertical sacral fractures ( Fig. 15.36 ) are rare and have to be differentiated from insufficiency fractures in osteopenia that have usually both a vertical and horizontal course. (radiologykey.com)
  • A lateral force vector characteristically causes transverse fractures of the pubic rami, vertical compression fractures of the sacrum, and fractures of the iliac wings, as well as pelvic instability caused by rotation of one or both hemipelvises (rotational instability). (radiologykey.com)
  • Fracture of the transverse process of L5 where the iliolumbar ligament attaches is a harbinger of an unstable pelvic injury. (radiologykey.com)
  • When accompanied by medial malleolus fracture or with deltoid ligament rupture the ankle is considered unstable. (ankleinfo.net)
  • Weber B) The SER fracture type II, has no medial injury, mechanically stable and do not require surgery. (ankleinfo.net)
  • The SER IV fracture has a medial component: either a medial malleolar fracture or a deltoid rupture. (ankleinfo.net)
  • Comminuted fracture of fibula above ankle mortise with medial malleolar fracture or deltoid injury. (ankleinfo.net)
  • All of them were closed fractures, including 20 cases of medial malleolus fracture, 37 cases of complete medial malleolus but deep and shallow rupture of deltoid ligament. (bvsalud.org)
  • Treatment can be nonoperative or operative depending on fracture displacement, ankle stability, presence of syndesmotic injury, and patient activity demands. (orthobullets.com)
  • C - Fractures above the joint line, generally with syndesmotic injury. (ankleinfo.net)
  • The fracture is proximal to the plafond, and may be as high as fibular neck (Maisonneuve) with associated syndesmotic injury. (ankleinfo.net)
  • Damage to adjacent structures such as nerves, muscles or blood vessels, spinal cord, and nerve roots (for spine fractures), or cranial contents (for skull fractures) may cause other specific signs and symptoms. (wikipedia.org)
  • Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading. (radiopaedia.org)
  • 6. Fredø HL, Rizvi SA, Lied B, Rønning P, Helseth E. The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway. (radiopaedia.org)
  • It is also important to palpate the calf proximally (near the knee) because there may be an associated high fibula fracture[citation needed](Maisonneuve fracture). (wikipedia.org)
  • Type 3 injuries (double breaks in the pelvic ring) include straddle fractures (vertical fractures of both superior pubic and ischiopubic rami or unilateral vertical rami fractures associated with symphyseal diastasis) ( Fig. 15.39 ) and injuries with complete disruption of both the anterior and posterior pelvic ring (e.g. (radiologykey.com)
  • Because all ligaments stabilizing the osseous pelvic ring (e.g., iliolumbar, anterior and posterior sacroiliac, and sacrospinous and sacrotuberous ligaments) are affected in this type of injury, the pelvic instability is most severe and both rotationally and vertically unstable. (radiologykey.com)
  • The quality of reduction of distal tibial articular surface (based on Ketz-Sanders standard), the reduction of tibiofibular syndesmosis (the anterior and posterior distances of distal tibiofibular syndesmosis and the lateral ankle twist angle measured by CT scan at 10 mm above the ankle joint line), and the fracture healing were evaluated. (bvsalud.org)
  • The calcaneofibular ligament (CFL), which connects the fibula to the calcaneus, or heel bone, also provides lateral support. (wikipedia.org)
  • In the unstable jumper's fracture ( Fig. 15.41 ), dissociation of the central portions of the sacrum from its lateral portions occurs by bilateral vertical sacral fractures, most commonly through the neural foramina representing the weakest points in the sacrum. (radiologykey.com)
  • Type 1 injuries include avulsion fractures that occur at tendinous attachment sites, such as the anterosuperior and anteroinferior iliac spines, ischial tuberosity, and iliac crest. (radiologykey.com)
  • An ankle fracture is a break of one or more of the bones that make up the ankle joint. (wikipedia.org)
  • The ankle joint is a highly constrained, complex hinge joint composed of three bones: the tibia, the fibula, and the talus. (wikipedia.org)
  • In addition to these views, a full-length view of the tibia and fibula may be necessary to evaluate for injuries to the proximal fibula associated with Maisonneuve fractures. (wikipedia.org)
  • Ankle fractures are very common injuries to the ankle which generally occur due to a twisting mechanism. (orthobullets.com)
  • Stable pelvic fractures ( Fig. 15.34 ) do not disrupt the osseous ring formed by the pelvis and sacrum (type 1 injuries) or disrupt it in only one place (type 2 injuries), whereas unstable fractures ( Fig. 15.35 ) completely disrupt the ring in two or more places (type 3 injuries). (radiologykey.com)
  • Type 2 injuries (single break in the pelvic ring) include ipsilateral fractures of the superior and inferior pubic (ischiopubic) rami, fracture of the pubic body adjacent to the symphysis, subluxation of one sacroiliac joint ( Fig. 15.37 ) or the pubic symphysis, and a fracture paralleling the sacroiliac joint ( Fig. 15.38 ). (radiologykey.com)
  • Pelvic fractures are frequently associated with severe soft tissue injuries, including vascular lacerations, compression or disruption of peripheral nerves, and perforation of the urinary bladder, urethra, rectosigmoid, and anus. (radiologykey.com)
  • BACKGROUND: Ankle syndesmosis injuries are common and range in severity from subclinical to grossly unstable. (bvsalud.org)
  • Patients with ankle fractures may have variable findings on physical examination. (wikipedia.org)
  • Routinely obtaining radiographs following an ankle injury is not cost-effective, because fewer than 15% of affected patients have a fracture. (medscape.com)
  • Patients without fractures are identified reliably on physical examination. (medscape.com)
  • Osteoporotic ankle fractures in frail patients are becoming more and more frequent in daily practice and represent a therapeutic challenge for orthopaedic surgeons. (bioscientifica.com)
  • The decision to operate on these patients is complex because conservative treatment is poorly tolerated in unstable fractures and conventional open reduction and internal fixation is associated with a high rate of complications. (bioscientifica.com)
  • The authors conducted a narrative review of the literature on primary tibiotalocalcaneal nailing of ankle fractures in frail patients and categorized the different factors to consider when treatment is indicated for this conditon. (bioscientifica.com)
  • Amongst multiply injured patients ankle fractures are prognostically important, being related to poor functional outcomes. (ankleinfo.net)
  • They reviewed 163 patients with stable ankle fractures over a period of 8 years. (ankleinfo.net)
  • Some studies have directly compared the outcome of conservative and surgical treatment, however it is difficult to establish a sound conclusion due to flaws in study designs, smaller no of patients and variation in fracture patterns. (ankleinfo.net)
  • Another common type 1 injury represents a unilateral pubic ramus fracture (usually in the superior ramus) occurring in elderly patients after a fall or prosthetic hip replacement surgery and in athletes as stress fracture. (radiologykey.com)
  • METHODS: The clinical data of 57 patients with closed Lauge-Hansen pronation-external rotation type â £ ankle fracture treated by full repair strategy (fracture, ligament, and cartilage repair) under small incision between January 2012 and January 2017 were retrospectively analyzed. (bvsalud.org)
  • All patients achieved bone healing without bone nonunion and malunion at 12 months after operation. (bvsalud.org)
  • Multiple classification schemes are used to classify ankle fractures. (medscape.com)
  • Classification systems of pelvic fractures combining the direction of the force that created the injury with the fracture pattern seen radiographically allow a highly specific injury description and are preferred by orthopedic surgeons ( Table 15.1 ). (radiologykey.com)
  • Non-operative treatment includes splinting or casting while operative treatment includes fixing the fracture with metal implants through an open reduction internal fixation (ORIF). (wikipedia.org)
  • Admission criteria include open fracture, unstable fracture requiring urgent operative stabilization, and the presence of or potential for neurovascular compromise (eg severely comminuted pilon fracture causing a compartment syndrome). (medscape.com)
  • Non-operative treatment of unstable ankle fractures is associated with a non-union rate of between 48 and 73% compared to 0 and 19% after operative treatment. (ankleinfo.net)
  • Difficulty of ambulation, age over 65 years old, deteriorated baseline state and instability of the fracture were the most frequently considered factors. (bioscientifica.com)
  • One form of malunion is the malrotation of a bone, which is especially common after femoral and tibial fractures. (wikipedia.org)
  • Ankle fractures account for 9% of all fractures, second highest in adults, only preceded by femoral neck fractures. (ankleinfo.net)
  • Some fractures may lead to serious complications including a condition known as compartment syndrome . (wikipedia.org)
  • Ankle fractures may result from excessive stress on the joint such as from rolling an ankle or from blunt trauma. (wikipedia.org)
  • Osteoporotic ankle fractures result from mechanical forces that would not ordinarily result in fracture, known as 'low-energy' trauma, such as those equivalent to a fall from a standing height or less. (bioscientifica.com)
  • [1] A bone fracture may be the result of high force impact or stress , or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis , osteopenia , bone cancer , or osteogenesis imperfecta , where the fracture is then properly termed a pathologic fracture . (wikipedia.org)
  • Malgaigne fracture, bucket handle fracture, and pelvic "dislocation") ( Fig. 15.40 ). (radiologykey.com)
  • An anteroposterior or posteroanterior force vector produces vertically oriented pubic rami fractures and disruption of the pubic symphysis and the sacroiliac joints, resulting in pelvic "dislocation" ("sprung" pelvis or "open book" injury). (radiologykey.com)
  • Because a patient with ankle fracture often presents with symptoms similar to those of an ankle sprain, a complete and thorough examination of the involved extremity is needed to avoid misdiagnosis and prevent unnecessary radiographs. (medscape.com)
  • In addition to standard plain radiographs, CT scan may be useful in highly comminuted fractures for mapping out fracture anatomy and preoperative planning. (ankleinfo.net)
  • The likelihood of a second break in the pelvic ring (type 3 injury) increases with a greater degree of joint diastasis or fracture displacement at the primary injury site. (radiologykey.com)
  • B - Fracture begins at joint level and extends proximally in an oblique fashion. (ankleinfo.net)
  • An inferosuperior force vector produces vertically oriented fractures of the pubic rami and disruption of the sacroiliac joints and sacral or ilial fractures, paralleling this joint. (radiologykey.com)
  • Unless neurovascular compromise is noted, reduction is best deferred to the orthopedic consultant when an unstable ankle fracture is diagnosed. (medscape.com)
  • Other complications may include non-union, where the fractured bone fails to heal, or malunion, where the fractured bone heals in a deformed manner. (wikipedia.org)
  • In a displaced, fracture the skin is sometimes tented over a sharp edge of broken bone. (wikipedia.org)
  • The sharp fragments of broken bone sometimes tear the skin and form a laceration that communicates with the broken bone or joint space. (wikipedia.org)
  • c) Cartilage of the calli is replaced by trabecular bone. (wikipedia.org)
  • These fractures occur commonly in children before closure of the corresponding physis (cartilage plate) and athletes secondary to forcible muscular contraction. (radiologykey.com)
  • Typically evaluation begins with x-rays, which can provide information about the mechanism of injury, severity of injury, and stability of fracture. (wikipedia.org)
  • Management of ankle fractures depends on accurate determination of the nature and severity of the injury. (ankleinfo.net)
  • Symptoms of an ankle fracture can be similar to those of ankle sprains (pain, swelling, limited range of motion), though typically they are often more severe by comparison. (wikipedia.org)
  • The whole process may take up to 18 months, but in adults, the strength of the healing bone is usually 80% of normal by 3 months after the injury. (wikipedia.org)
  • Ankle fractures are common, occurring in over 1.8 per 1000 adults and 1 per 1000 children per year. (wikipedia.org)
  • Ankle fractures are the most common fractures of the lower limbs found in emergency services. (medscape.com)
  • Most common ankle fracture. (ankleinfo.net)
  • hence, in children, cervical fractures are more common in upper vertebrae. (radiopaedia.org)
  • C2 (~30%) and C7 (~20%) are the most commonly fractured levels 7 . (radiopaedia.org)
  • Hutchinson and Barrie suggested that the majority of ankle fractures seen in clinic are stable, are not likely to displace and do not require plaster casting to achieve union in a good position. (ankleinfo.net)
  • This is known as an open fracture and has a high incidence of infection if not promptly treated. (wikipedia.org)
  • The skin should be carefully examined, paying particular attention to any openings or breaks in the skin that could be due to an open fracture. (wikipedia.org)
  • If the neurovascular status of the extremity is compromised, the fracture should be reduced as soon as possible and reduction should be maintained during the healing period with a cast, an external fixator, or open reduction internal fixation (ORIF). (medscape.com)
  • Healing bone callus on average is sufficiently mineralized to show up on X-ray within 6 weeks in adults and less in children. (wikipedia.org)
  • This initial "woven" bone does not have the strong mechanical properties of mature bone. (wikipedia.org)
  • showed there was insufficient evidence to justify surgical management of type B ankle fractures. (ankleinfo.net)
  • OBJECTIVE: To investigate the safety, feasibility, and efficacy of full repair strategy under small incision in the treatment of closed Lauge-Hansen pronation-external rotation type â £ ankle fracture. (bvsalud.org)
  • CONCLUSION: Full-repair strategy under small incisions for the treatment of Lauge-Hansen pronation-external rotation type â £ ankle fracture is effective and safe. (bvsalud.org)
  • In potentially unstable fractures treated non-operatively with cast application, it may be necessary to follow the patient weekly with serial x-rays to assess the position of the fracture, with cast removal at approximately 6 weeks depending on clinical and radiographic evidence of healing. (ankleinfo.net)
  • In more severe cases, the bone may be broken into several fragments, known as a comminuted fracture . (wikipedia.org)
  • Involuntary muscle spasms trying to hold bone fragments in place. (wikipedia.org)
  • Collagen's rubbery consistency allows bone fragments to move only a small amount unless severe or persistent force is applied. (wikipedia.org)
  • Chronic medical conditions, such as diabetes, peripheral vascular disease, and metabolic bone disease, may affect examination findings and treatment plans. (medscape.com)
  • Approximately 53% of these fractures are unstable and are treated surgically. (medscape.com)