• Emergency medicine physicians usually label ankle fractures according to the number of fractures in the ankle (unimalleolar, bimalleolar, trimalleolar). (medscape.com)
  • The deltoid ligament provides support to the medial part of the ankle (closest to the midline). (wikipedia.org)
  • When accompanied by medial malleolus fracture or with deltoid ligament rupture the ankle is considered unstable. (ankleinfo.net)
  • The fracture lines appear to occur between the anterior and posterior inferior tibiofibular ligaments, and the medially fused physis or deltoid ligament. (bvsalud.org)
  • 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)
  • The talus and the fibula are connected by a strong group of ligaments, which provide support for the lateral aspect of the ankle. (wikipedia.org)
  • However, in the setting of an ankle fracture, the talus can become unstable and subluxate or dislocate. (wikipedia.org)
  • Ankle fractures refer to fractures of the distal tibia, distal fibula, talus, and calcaneus. (medscape.com)
  • The true ankle joint contains the tibia (medial wall), fibula (lateral wall), and talus (the floor upon which the tibia and fibula rest) and allows dorsiflexion and plantar flexion, or the "up and down" movement of the ankle. (medscape.com)
  • First, the medial malleolus is shorter than the lateral malleolus, allowing the talus to invert more than evert. (medscape.com)
  • 1) Anatomy: The ankle joint is made up of the medial malleolus (distal tibia), the lateral malleolus (distal fibula), posterior malleolus (distal posterior portion of tibia) all of which fit tightly around the talus to form the mortise. (emory.edu)
  • Pilon Fractures: The talus is driven upward into the tibial plafond resulting a comminuted intraarticular trimaleolar fracture with extension into the distal tibial metaphysis usually from a fall from height. (emory.edu)
  • 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)
  • 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)
  • 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)
  • Treatment can be nonoperative or operative depending on fracture displacement, ankle stability, presence of syndesmotic injury, and patient activity demands. (orthobullets.com)
  • Difficulty of ambulation, age over 65 years old, deteriorated baseline state and instability of the fracture were the most frequently considered factors. (bioscientifica.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 fibular fracture may require a bridging technique or a nail. (ankleinfo.net)
  • 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 and pilon fractures are common injuries and can range in severity from low-energy rotational injuries to high-energy fractures of the articular surface. (bvsalud.org)
  • We describe a technique that involves the use of novel polyaxial locking struts in conjunction with circular external fixation that can be used as a temporary form of external fixation or as definitive treatment of high-energy ankle and pilon fractures. (bvsalud.org)
  • Comminuted fracture of fibula above ankle mortise with medial malleolar fracture or deltoid injury. (ankleinfo.net)
  • Successful outcomes in the surgical treatment of the fractured ankle require methods that respect the soft tissue envelope and establish a stable mortise for functional rehabilitation. (bvsalud.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)
  • 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)
  • 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)
  • Ankle fractures in patients with osteopenia and in diabetic patients with deranged bone remodeling constitute high-risk injuries that may result in catastrophic complications. (bvsalud.org)
  • Aims: Triplane ankle fractures are complex injuries typically occurring in children aged between 12 and 15 years. (bvsalud.org)
  • An independent Paediatric Orthopaedic Trauma Surgeon assessed all CT scans and classified the injuries as n-part triplane fractures. (bvsalud.org)
  • Conclusion: This fracture mapping study reveals that triplane ankle fractures have a characteristic Y-pattern, and acknowledges the weakness created by the physis, however it also challenges classic teaching that the specific fracture pattern at the level of the joint of these injuries relies on advancing closure of the physis with age. (bvsalud.org)
  • These fractures occur commonly in children before closure of the corresponding physis (cartilage plate) and athletes secondary to forcible muscular contraction. (radiologykey.com)
  • 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)
  • An ankle fracture is a break of one or more of the bones that make up the ankle joint. (wikipedia.org)
  • The SER IV fracture has a medial component: either a medial malleolar fracture or a deltoid rupture. (ankleinfo.net)
  • Foot and ankle surgeons are commonly confronted with the surgical dilemma on when and how to best surgically address trimalleolar ankle fractures with a posterior malleolar component. (bvsalud.org)
  • This article aims to evaluate the current literature on posterior malleolar ankle fractures, approaches to fixing the posterior malleolus, and outcomes and complications of these procedures. (bvsalud.org)
  • B - Fracture begins at joint level and extends proximally in an oblique fashion. (ankleinfo.net)
  • One form of malunion is the malrotation of a bone, which is especially common after femoral and tibial fractures. (wikipedia.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)
  • 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)
  • 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)
  • 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: A fracture mapping study was performed in 83 paediatric patients with a triplane ankle fracture treated in three trauma centres between January 2010 and June 2020. (bvsalud.org)
  • Approximately 53% of these fractures are unstable and are treated surgically. (medscape.com)
  • 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)
  • 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)
  • 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)
  • 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)
  • 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)
  • 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)
  • Unless neurovascular compromise is noted, reduction is best deferred to the orthopedic consultant when an unstable ankle fracture is diagnosed. (medscape.com)
  • 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)
  • Some fractures may lead to serious complications including a condition known as compartment syndrome . (wikipedia.org)
  • 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)
  • 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)
  • We present the principles of treatment in high-risk ankle fractures, operative treatment philosophy illustrating techniques frequently used at our institution, and a review of current literature. (bvsalud.org)
  • Weber B) The SER fracture type II, has no medial injury, mechanically stable and do not require surgery. (ankleinfo.net)
  • 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)
  • Malgaigne fracture, bucket handle fracture, and pelvic "dislocation") ( Fig. 15.40 ). (radiologykey.com)
  • This may involve either direct fixation of the posterior malleolus or indirect stabilization with the fixation of the medial and lateral malleoli and trans-syndesmotic fixation. (bvsalud.org)
  • 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)
  • 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)
  • Classic teaching that closure of the physis dictates the overall fracture pattern, based on studies in the 1960s, has not been challenged. (bvsalud.org)
  • 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)
  • 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)
  • C2 (~30%) and C7 (~20%) are the most commonly fractured levels 7 . (radiopaedia.org)
  • Typically evaluation begins with x-rays, which can provide information about the mechanism of injury, severity of injury, and stability of fracture. (wikipedia.org)
  • Pelvic fractures must be assessed for both stability and acetabular involvement. (radiologykey.com)
  • The calcaneofibular ligament (CFL), which connects the fibula to the calcaneus, or heel bone, also provides lateral support. (wikipedia.org)
  • 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)
  • 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)
  • 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)