# - tibia + ankle # Flashcards
TIBIAL
Most common fracture in ?, and ? fractures are common due to its ? position.
Remember to ensure the whole length of the ? and ? are imaged, as well as the ? and ? joints.
A ? displaced or nondisplaced fracture can be treated with a full
length ?;
o Mid-? to ? necks, knee slightly ?, ankle ? degrees.
adults open subcut tibia fibula ankle knee min cast thigh metatarsal flexed 90
TIBIAL
Displaced fractures will require ? under ? ? with ?
guidance before ? length cast application.
The limb is ? and observed for ?h for signs of ? ?.
The position should be checked with ? at ? weeks.
At ? weeks, change to a ? ? cast to allow some ? ?
(promotes healing).
reduction GA xr full elevated 48 compartment syndrome xr two four below knee weight bearing
ANKLE
Common injury seen in young ? or ? ? women.
There are three ‘malleoli’ that can be fractured in the ankle;
o ? or ? malleoli.
o ? malleolus: formed by the ? tibia.
Most common mechanism is ? and ? rotation of the joint leading to the ? malleolus shearing off.
athletes older osteoporotic lateral medial posterior abduction lateral lateral
ANKLE
On examination there will be ? pain and an inability to ?.
Order an ?, ? and ‘mortoise’ (? film facing inferior ? joint) views.
The ‘?’ classification is used to classify ? malleolus fractures based on their relationship to the ? (? joint)
intense stand ap lateral oblique tibfib weber lateral syndesmosis tibfib
ANKLE
o Weber A: Fracture is ? the level of the syndesmosis.
• Syndesmosis is ?.
o Weber B: Fracture ? the level of the syndesmosis.
• Syndesmosis may be ? intact.
o Weber C: Fracture ? the level of the syndesmosis.
• Syndesmosis is ?
below intact at partially above non-intact
ANKLE
’? ?’ is also an important indicator of ? in the ankle
–If the talus no longer exhibits an equal joint ?around its ? with the ? and ?, this is highly indicative of ankle ? that will require ? management.
talar shift instability space articulation tib fib instability surgical
ANKLE
Mx
Weber A fractures;
o Generally ? and thus ? require operative management.
o ? weeks plaster of paris ? usually sufficient.
Weber C fractures;
o ? stable, thus require ???? if the patient is fit for ?.
stable rarely 6 casting never orif surgery
Weber B fractures;
o A trial of ? management is often tried, with repeat X-rays at weeks ?, ? and sometimes ? if any doubt remains as to whether the
fracture is ?(i.e. if there is any ? ?).
Fractures of more than one ? are almost always unstable, and thus management is ?.
conservative 1,2 3 displaced talar shift malleoli operative
Ottowa Rules;
An X Ray of the ankle is required only if the patient is unable to ? ?, has ? and ? ? at the ? or ? malleolus.
An X Ray of the foot is required only if the patient is unable to ? ? and has ?tenderness over the ? or base of the ?th metatarsal.
wt bear pain bony tenderness med lat wt bear bony navicular 5th
The Salter Harris criteria is also important to know;
Type ? fractures are rare, with type ? fractures by far the most common.
1
2
Type 1 S - ? Type 2 A - ? Type 3 L - ? Type 4 T - ? Type 5 (e)R - ?
S - straight across A - above L - lower/beLow) T - Two (chunks) or Through R - cRushed
