Ankle fracture

Question 1

How does someone with an ankle fracture present?

Answer 1

Ankle pain following trauma
Visible deformity
May also have neurovascular compromise
Inability to weight bear

Question 2

What bones make up the ankle joint?

Answer 2

Tibia ( medial malleolus)
Fibula (lateral malleolus)
Talus (sits in the mortise made by the above bones)

Question 3

How and when is an ankle fracture managed conservatively?

Answer 3

Fracture reduction - to realign
(after this repeats neurovascular exam and xray)
Splint used to immobilise the leg
Then casting

Done for

• non displaced medial malleolus fractures
• fractures below or at the level of the syndesmosis (where the tibia and fibula join ) without talar shift
• people who are unfit for surgery

Question 4

How and when is an ankle fracture managed surgically?

Answer 4

surgery - open reduction and internal fixation

Done for

• displaced bi or tri-malleolar fractures
• fractures with talar shift
• fractures that occur above the level of the syndesmosis
• open fractures

Question 5

What are some complications of surgical open repair and fixation?

Answer 5

Surgical site infections
DVT or PE
Neurovascular injury
Non-union
Metalwork prominence

Question 6

What is an ankle sprain?

Answer 6

Ligament injuries to the ankle

Question 7

How does an ankle sprain present?

Answer 7

Often after an inversion injury on plantar flexed ankle

Swelling and pain
Inability to weight bear
Tenderness over affected ligament

Question 8

How is an ankle sprain managed?

Answer 8

XRAY - to ensure no bony injury

Analgesia
Ice
Elevation
Early mobilisation