Ankle Fractures (Pod med) Flashcards Preview

PodMed > Ankle Fractures (Pod med) > Flashcards

Flashcards in Ankle Fractures (Pod med) Deck (53):
1

Remember these structures

2

Remember these structurez

3

The OTTAWA ankle rules:

If pain exist in A

PLUS one or more of the following:

B

C

D

 

 

A : near one or both of the malleoli 

 

B: Age < 55 years old

C: Inability to weight bear

D: Bone tenderness over the the posterior edge or tip of either malleolus 

4

What is the normal space for Tib-Fib clear space on the mortise view?

less than 5 mm

5

What is Mortise x-ray view?

With the A in B degrees of C rotation 

 

 

 

Mortise view is useful in valuation of articular surface

between D and E 

 

A: Ankle

B: 15-25 degrees

C: Internal rotation 

 

 

D: Talar dome

E: Mortise 

6

Where is the Medial Clear space?

What is the normal value?

 

Medial clear space is between 

Lateral border of medial malleous 

and 

Medial Talus 

The normal value is less than 4 mm

And more than 4mm suggest lateral shift of talus

7

Fibular fracture above the level of the ankle joint indicates

that the A is torn.

 

 

 

A: Distal anterior tibiofibular ligament

 

 

 

8

Fracture of fibula above its anterior tubrcle strongly suggests that the B is completely distrupted. 

 ​B: Tibiofibular syndosmosis

9

Fracture of fibula above the level of ankle joint WITHOUT accompaying fracture of the medial malleolus indicates rupture of A 

A deltoid ligament

10

A fracture of the medial malleolus indicates that the deltoid ligament is intact 

A Transverse 

 

11

What is Maison neuve fracture?

High fracture of the fibula 

fracture of the medial malleolous

Tear of tibiofibular ligament 

Rupture of interoseous membrane 

 

12

What does the inversion stress view shows?

This angle helps to diagnose tears of lateral collateral ligament. 

13

The anterior-draw stress film provides a useful measurment for determining injury to the 

A ligament

 

A : anterior talofibular ligament 

 

 

14

Values of upto A of seperation between the talus and distal tibia are considered normal 

Values between B and C may be normal or abnormal and the opposite ankle should be tested

Values above D are always abnormal 

A: 5mm

B: 5mm and C: 10mm

D: 10mm

15

What are the primary goals for management of ankle fractures?

 

  • Restore function 
  • Return to normal function 

16

What are different types of fractures?

Hint: 8 different 

 

  1. Spiral
  2. Oblique
  3. Transverse 
  4. Comminuted
  5. Wedge
  6. Impacted/Compression
  7. Displaced
  8. Open or compound

17

Supination Adduction 

It occurs in A% of ankle fractures

The foot is fixed on the ground in B position with an C force is applied to the talus

 

 

 

 

 

A: 20-25%

B: Supination C: Adduction 

18

Suppination Adduction 

Stage 1

Supination results in a tear of the A ligament

or

An B fracture of the C below the level of tibial plafond

 

A: Lateral collateral ligament

B: avulsion 

C: Lateral malleolus

 

19

Supination Adduction 

Stage 1

A rupture with or without B fragment and or C fracture of D malleoli below the ankle mortise 

 

 

A: lateral ligament 

B: Avulsion 

C: transverse 

D: lateral 

 

20

Supination Adduction

Stage 2

A fracture of the B malleoli 

 

 

A: Vertical 

B: Medial 

 

21

Supination Adduction

Stage 2

More talar tilt results in the medial malleolus being 

pushed of in a A or B way 

 

 

A: Vertical 

B: Oblique 

22

What is the name of this fracture?

 

Supination Adduction

 

23

What does the grey arrow show?

What does the orange arrow show?

Grey arrow: Lateral injury, transverse fibular fracture below or at the level of mortise

Orange arrow: Medial injury, vertical shear type, medial malleolar fracture 

 

24

Pronation- Abduction 

It occurs very A

Stage 1: B medial C fracture 

Or D ligament rupture

 

A: Rarely 

B: Transverse        C: Malleoli

D: Deltoid 

25

Pronation Abduction

Stage 2: As the abductory force continues to push the talus A

Creating injury to both B and C

In this stage the D is still intact 

Pronation Abduction 

A: Laterally 

B: Anterior tibiofibular 

C: Posterior tibiofibular 

D: interossious ligament

26

Pronation Abduction 

Stage 3: In this stage the abductory force has continued into the fibula creating a fracture at A

that is B on AP view

But appears C on a lateral view 

Pronation Abduction 

 

A: at or above the ankle joint 

B: short and oblique

C: transverse 

 

 

27

Pronation Abduction 

Stage 3: A fracture typically proximal to mortise

often with a B fragment 

The lateral view is important to differentiate it from 

C fracture 

 

Pronation Abduction 

A: Fibula

B: Butterfly 

 

C: Supination Eversion 

 

28

Supination External rotation 

This is the A common fracture 

In stage 1:

Rupture of B ligament 

Or a fracture of C, also known as D

Supination External rotation 

A: Most common 

B: Anterior tibiofibular ligament

C: Lateral distal tibia

D: Tillaux- Chaput fracture 

 

 

29

Supination External Rotation 

Stage 2: Spiral fracture of A at the B level 

The most commonly encountered ankle fracture

 

Supination External Rotation

A: Fibula 

B: Syndosmotic level 

30

Supination- External Rotation 

Stage 3: As the force progresses it will involve either a rupture of A 

Or the fracture of B of the tibia 

Also known as the C fracture 

 

 

Supination- External Rotation 

A: Posterior tibiofibular ligament

 

B: Posterior Malleolus of the tibia

C: Volkman's fracture

 

31

Supination External rotation

Stage 4: A ligament tear or B transverse fracture

 

A: Deltoid B: Medial Malleolus 

 

32

Supination- External Rotation 

Hallmarks of this injury:

Injury begining at the A aspect of the fibula 

 

 

A: Lateral 

33

Pronation External rotation 

With the foot in a fixed pronated position, the force 

starts along the A aspect of the tibia

Stage 1: Rupture of B ligament

or transverse fracture of

 

A: Medial 

B: Deltoid

C: Medial Malleolus 

 

34

Pronation external rotation 

As the injury progresses forward to stage 2, the talus rotates further laterally putting tension on the A ligament resulting in either rupture of this ligament or an avlusion fracture of B Also known as C fracture

 

 

 

A: Anterior inferior tibiofibular ligament

B: anterior portion of fibula or tibia 

C: Volkman's fracture

35

Pronation External rotation 

As the force continue pass stage 2, 

Rupture of A memabrane begin to occur distally at the level of B 

 

 

A: Intersous membrane

B: Ankle joint 

 

36

Pronation External Rotation 

Stage 3 fracture 

High A fracture with B

This fracture can be at various levels of fibula

 

 

 

A: Fibular fracture 

B: Interosseus membrane

 

 

37

Pronation External rotation 

If the forces progress into stage 4 

either a rupture of A 

or a fracture of B also know as C occurs

True diastasis fracture

 

 

 

A: posterior tibiofibular

B: Posterior malleoules 

C: Volkman fracture 

 

38

Pronation External Rotation 

The main hallmark is the A

 

 

A: High fracture of the fibula 

39

What stage and type of injury has occured?

A. 

B. 

 

A. Stage 4

B. Pronation External rotation

because the fracture has occured proximally 

 

40

Exam

Weber Classification 

Weber A

Weber B

Weber C

Concept! 

 

A: Fibula distal to mortise 

B. Fibula at level of mortise

C: Fibula proximal to mortise

The higher the the fibula the more severe the injury 

 

41

 

Maionneure fracture:

Fracture of A with B disruption

 

 

A: Proximal fibula

B: Syndesmotic disruption

 

42

 

Volkman Fracture

Fracture of A attachment of B

C fracture type

 

 

 

 

A: tibial attachment

B: PITFL

C: Posterior Malleolar fracture

 

 

43

Tillaux- Chaput fracture

Fracture of tibial attachment of A

 

 

 

A: AITFL 

 

44

Pott fracture

In Pott fracture,

the fibual is fractured above A

The B is ruptured

The C is laterally subluxed 

 

 

A: the intact distal tibiofibular syndesmosis 

B: Deltoid

C: Talus 

45

 

Dupuytern fracture

This fracture usually occurs A above the B 

With disruption of the C ligament 

and Typically tear of the D leading to ankle instability

 

A: 2 to 7 cm 

B: dital tibiofibualr syndesmosis 

C: Medial collateral ligament

D: syndosmosis 

 

 

46

Wagstaffe-Lefort fracture 

In this fracture, the medial portion of the A is avulsed 

at the insertion of the B 

the C however, remains intact 

 

 

A: Fibula

B: anterior tibiofibular ligament

C: ligament

 

47

Bosworth fracture dislocation

A fracture with posterior dislocation of B segment behind tibia 

 

A: Fibular fracture

B: Proximal fibular

48

The terms A, B, and C all have been used to intraarticular fractures of the distal tibia. 

A: tibial plafond fracture

B: Pilon fracture

C: Disal tibial explosion fracture

 

 

 

49

 

Classify this fracture

 

 

Supination abduction (external rotation)

stage 4

 

50

 

Classify this fracture?

 

 

Pronation abduction 

stage 3

 

51

 

What are the 3 indications for non-operative short leg walking cast/boot?

  1.  
  2.  
  3.  

 

 

  1. Isolated nondisplaced medial malleolus fracture or tip avulsions
  2. Isolated lateral malleolus fracture with < 3mm displacement and no talar shift
  3. Posterior malleolus fracture with < 25% joint involvment     

52

EXAM

What are the 7 indications for Operative open reduction internal fixation?

  1.  
  2.  
  3.  
  4.  
  5.  
  6.  
  7.  

 

  1. Any talar displacement
  2. Displaced isolated medial malleolar fracture
  3. Displaced isolated lateral malleolar fracture
  4. Bimalleolar fracture and bimalleolar equivalent fracture
  5. Posterior malleolar fracture with > 25% involvment
  6. Bosworth fracture-dislocations
  7. Open fractures
  8.  

53