overall lauge-hanson is flawed.ĥ) Summers HD et al.
A novel methodology for the study of injury mechanism: ankle fracture analysis using injury videos posted on. evaluating normal syndemosis, reliability of tib-fib overlap.Ĥ) Kwon JY et al. Radiographic evaluation of the normal distal tibiofibular syndesmosis. Ankle fractures resulting from rotational injuries. People are typically allowed to return to driving 9 weeks after their surgery (see blog post), but overall return to driving and other activities is determined by the surgeon treating the injury. However, sometimes it takes a while for people to return to their preinjury activity, and its not uncommon for it to take 1 year to return to normal. What is the long term outcome? Overall these injuries heal very well, with about 90% of people happy with their results. However, some surgeons will say that this ankle will heal well if it is treated in a cast for 4-6 weeks as long as the correct alignment can be obtained and held in position with the cast. In such cases, most surgeons recommend repairing the fracture to realign the ankle and return its stability. This indicates that even though there is not fracture to inner ankle, there is a significant inner ligament tear, which makes the overall ankle unstable. Oftentimes, the outer ankle is broken and the “stress view” is abnormal.
FIBULA FRACTURE HOW TO
The bigger controversy in treatment is how to address a fracture of just the outside ankle (the lateral malleolus). The hardware is usually left inside the person after surgery, however it can be removed at a later time if it causes irritation, or if you just don’t like the idea of having metal inside your leg. The surgery involves using a metal plate and a few screws to hold the bone in the correct position while it heals. Most surgeons will agree that if both the inside and the outside ankle is broken (the fibula and the tibia), then surgery is recommended to ensure the correct alignment of the joint, thereby minimizing the risk of future arthritis. This extra x-ray (called a “stress view”) is helpful for determining treatment (if surgery is necessary).Įven though an ankle fracture is one of the most common injuries in orthopedics, there is a lot of controversy about the ideal treatment. If the lateral ankle (fibula bone) is broken, yet the inside ankle (tibia) is intact, an additional x-ray is typically ordered to determine ankle stability.
The fracture pattern will be different depending on the direction the ankle turned (in fact, doctors can look at an x-ray of a broken ankle and know exactly how the foot twisted at the time of injury). Three views by x-ray is typically sufficient to show a fracture. When examining the ankle, certain findings, such as tenderness within 6 cm of the ankle prominence or the inability to take more than 4 steps on the injured leg, suggest a fracture, and requires an x-ray. However, ankle sprains occur the same way and are much more common than fractures, and ankle sprains dont require x-rays (doctors try to avoid taking unnecessary x-rays to minimize radiation exposure). How is an Ankle Fracture diagnosed? An ankle fracture is suspected when someone describes a twisting injury to their ankle. The fibula and tibia are held together by a very thick ligament complex called the “Syndesmosis”, which can sometimes be torn in ankle fractures (it is also the ligament injured when we talk about “ high ankle sprains”). The fibula forms the outside ankle (called the lateral malleolus) and this is connected to the foot by two ligaments, the ATFL (which is injured in your common ankle sprains) and the CFL. The tibia forms the inside ankle (called the medial malleolus) and is connected to the foot by a very thick ligament called the “Deltoid Ligament” which often gets torn during an ankle fracture. As a quick review of the ankle anatomy (see picture), this joint consists of three bones: the two leg bones (the tibia which is the large bone in the leg, and the smaller fibula, which only bears about 10% of the weight) and the one foot bone (the talus). The severity of injury depends on the position of the foot when the injury occurs and also the force of the twisting motion. Most of the ankle fractures will also be accompanied by some form of ligament injury. The fibula (which forms the outer ankle) is the more commonly broken bone, but the inside ankle (the tibia bone) or both inside and outside ankles can be also brake. The most common injury is for the foot to roll inward (supination) while the ankle twists outward (external rotation). An ankle fracture is one of the most common fractures and it occurs with an excessive twisting motion to the ankle.
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