Ankle injuries are most commonly due to what?
Inversion injury and/or rotational force on a planted foot
When there is a lateral ankle sprain, which ligaments are affected?
- Anterior/posterior talofibular ligaments
- Calcaneofibular ligaments
How can sprains of the lateral ankle ligaments be characterised?
- Mild/moderate tenderness
- Fractures (usually only in osteoporotic bone)
Whih criteria are used to assess a possible ankle fracture in A&E
What is the purpose of the Ottawa criteria for potential ankle fractures?
It gives guidance on whether an X-ray is required or not
Which criteria merit an X-ray for an ankle injury?
- Severe localised tenderness of distal tibia/fibula
- Inability to weight bear for four steps
What consitutes a stable ankle fracture?
Isolated distal fibular fracture
What is the treatment for a stable ankle fracture?
Walking cast or splint for 6 weeks
What consitutes an unstable ankle fracture?
Distal fibular fracture with rupture of the deltoid ligament
What is the treatment for an unstable ankle fracture?
ORIF with plate and screws
What would cause suspicion of a ruptured deltoid ligament?
Medial bruising and tenderness
With talar shift, which way will the foot be rotated?
By definition, the deltoid ligament must be ruptured if there is no medial malleolar fracture in which two conditions?
- Talar shift occurring on a mortise AP view
- Talar tilt with the talus and tibial plafond being non parallel
Talar shift poses a greatly increased risk of what?
Post traumatic OA
What treatment is required if talar shift is present?
Anatomical reduction and rigid internal fixation (ORIF)
Bimalleolar fractures are ________ fractures
Bimalleolar fractures are unstable fractures
Why may ORIF be delayed by 1-2 weeks with ankle fractures?