ankle injury

Question 1

what is used to clinically examine that ankle to try and minimised the unnecessary use of X-rays?

Answer 1

Ottawa ankle rules

Question 2

what do the Ottawa ankle rules state?

Answer 2

X-rays are only necessary if there is pain in the malleolar zone and:

1. inability to weight bear for 4 steps
2. tenderness over distal tibia
3. bone tenderness over distal fibula

Question 3

what classification is used to describe ankle fractures?

Answer 3

Weber classification

Question 4

what is the Weber classification related to?

Answer 4

the level of fibular fracture

Question 5

what is a type A Weber classification?

Answer 5

fibular fracture below the syndesmosis

Question 6

what is a type B Weber classification?

Answer 6

fibular fractures start at the level of tibial plafond and may extend proximally to involve the syndesmosis

Question 7

what is a type C Weber classification?

Answer 7

fibular fracture above the syndesmosis which may itself be damaged

Question 8

what is a Maisonneuve fracture?

Answer 8

a subtype that occurs with spiral fibular fracture that leads to disruption of syndesmosis with widening of the ankle joint. requires surgery.

Question 9

how is an ankle fracture managed?

Answer 9

depends on stability of ankle joint and pt co-morbidities

Question 10

what should be done for all ankle fractures?

Answer 10

promptly reduced to remove pressure on the overlying skin and subsequent necrosis

Question 11

what do young pts with unstable, high velocity or proximal injuries leading to ankle fracture usually require?

Answer 11

surgical repair, often using a compression plate

Question 12

how are elderly pts with potentially unstable injuries managed?

Answer 12

conservative mx as their thin bone does not hold metalwork well