ANKLE FRACTURES AND FRACTURE-DISLOCATION.

1
ANKLE FRACTURES AND FRACTURE-DISLOCATION.

• Fractures and fracture-dislocation of the
  ankle are common.
• Mechanisms twisting slipping.
• The injury may be caused by direct trauma.

2
CLASSIFICATION.

• Fractures of the ankle can be classified
  according to
• Mechanism of injury. The Lauge-Hansen
  classification. This classification is very
  complex.
• Anatomical . The relation of the fracture
  of the fibula to the syndesmosis Weber
  A , Weber B and Weber C.

3
CLINICAL FEATURES.

• History of twisting the ankle.
• Clinically the ankle is swollen, deformed (
  if there is fracture-dislocation), and
  tender.
• Identify areas of tenderness because they
  are a clue to the diagnosis and treatment.
• Commonly closed injuries.

4
INVESTIGATIONS.

• A fracture-dislocation of an ankle is a
  clinical diagnosis. The dislocation must be
  reduced and the ankle immobilized before
  sending patient to X-rays.
• You must request three X-rays AP, LATERAL
  AND OBLIQUE. Each X-ray film must include
  the ankle and knee joints.

5
PRINCIPLES OF TREATMENT.

• Reduce fracture-dislocations urgently.
• Always splint the ankle.
• Elevate the ankle to decrease swelling.
• We operate all ankle fractures except those
  with a minimally displaced lateral
  malleolus with no medial tenderness.
• Fracture of an ankle unites in six weeks.

6
COMPLICATIONS.

• EARLY
• Skin breakdown esp. In fracture-dislocation.
• Vascular damage.
• Swelling plus blisters.

7
COMPLICATIONS ..

• Late
• Malunion.
• Non-union.
• Joint stiffness.
• Osteo-arthritis.
• Complex regional pain syndrome.
• THE END.