Flashcards in Ankle and Foot Deck (35):
What is the most frequently injured major joint in the body?
When should ankle radiographs be ordered according to the Ottawa ankle and foot rules?
- If the patient unable to bear weight
- If there is point tenderness in either malleolar zone, mid-foot zone, base of ﬁfth metatarsal, or at the navicular
The Ottawa ankle and foot rules are __% sensitive for detecting signiﬁcant fractures
When should advanced images be ordered?
When radiographic findings are...
Insufﬁcient to guide treatment
- After radiographic ﬁndings are negative when further injury is suspected
Inversion ankle sprains account for __% of all traumatic conditions at ankle
Inversion sprains damage the _____ collateral ligaments
What ligaments are the most frequently injured components of the LCL system
Anterior taloﬁbular and calcaneoﬁbular ligaments
Eversion sprains damage the _____ collateral ligaments
Are inversion or eversion sprains generally associated with bony damage? Explain why
Eversion, because the MCL has so much tensile strength that avulsion fractures and other fractures often occur before the MCL itself fails structurally and sustains damage
What other injuries are typically associated severe ankle sprains?
- avulsion fractures
- tearing of the distal tibiofibular syndesmotic complex
- ankle instability
When is joint instability revealed?
On routine radiographs or stress views by observing an abnormal position of the talus or increased width of ankle mortise
What is a Maisonneurve fracture?
An ankle sprain that disrupts the interosseous membrane a produces a spiral fracture at the proximal fibula
What are the 2 treatment options to restore the stability of the ankle mortise?
Surgical: Screw fixation followed by immobilization
What do ankle fractures frequently occur in combination with?
Ligamentous ruptures, avulsions, and other fractures
Generally, what is the MOI for a ankle fracture?
axial or rotational loading
What are the 3 anatomically classified ankle fractures?
What is a unimalleolar fracture?
A fracture of either the lateral or medial malleolus
What is a bimalleolar fracture?
A fracture of both the lateral and medial malleoli
What is a trimalleolar fracture?
fracture of both malleoli and the posterior rim of the tibia
What are 3 other fractures involving the ankle joint?
- Shaft fractures of the ﬁbula and tibia
- Comminuted fractures of the distal tibia
- Intra-articular fractures of the tibial plafond or talar dome
What is the goal when treating ankle fractures?
to stabilize fractures and reestablish architecture of ankle mortise
What is the most common complications of an ankle fracture?
non-union and degenerative joint changes associated with post-traumatic arthritis
What type of foot fracture is the most common? What is second?
What is the typical MOI for a talus fracture?
Tends to occur when a large force is applied through a dorsiﬂexed foot such as when a driver slams on their brakes in an auto collision
Are talar fractures considered intra-articular or extra-articular type fractures? Why?
Intra-articular, because ⅗ of the talus is covered with articular cartilage
Talar fractures are classified according to what?
Fractures of the talar head, body, or neck
What is the treatment for a non-displaced talar fracture?
immobilization in short-leg cast for 8-12 weeks and avoidance of weight-bearing for initial 6 weeks until radiographic evidence of healing
What is the treatment for a displaced talar fracture?
Surgery (ORIF) in order to restore subtalar joint congruity
What are common complications associated with talar fractures?
- Post-traumatic arthritis of the ankle and subtalar joints
Because the talus lacks blood supply what is it at risk of developing?
What are accessory bones of the foot?
Anomalous bones that usually form because of failure of one or more ossiﬁcation centers to unite with the main mass of bone
Accessory bones have an incidence rate as high as __%
What are the 3 accessory bones that occur with frequency?
- intermetatarsal ossicle (os intermetatarsale)
- external tibial ossicle (os tibiale externum)
- trigone ossicle (os trigonum)
How do accessory bones complicate the evaluation of foot injuries?
When present in the area of a suspected fracture they can mistaken for one