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Ankle Fractures

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European Surgical Orthopaedics and Traumatology

Abstract

Ankle fractures are common injuries. Currently their incidence lies between 100 and 200 fractures per 100,000 people-years. Isolated lateral malleolus fractures are the most common, accounting for approximately 70 % of all ankle fractures. Several classifications have been proposed, none of which appear to adequately cover the whole spectrum of these injuries. The Danis-Weber and OTA/AO classifications describe the anatomy of fracture configuration. The Lauge-Hansen classification is based on the mechanism of injury and can be more useful in assessment of fracture stability and decision-making with regard to management. All components of the injury (bone and soft tissue) should be identified in order to plan management (operative vs. non-operative). Assessment of stability is an essential part of decision-making as is utilization of appropriate fixation techniques. Weight-bearing antero-posterior radiographs can be used to distinguish between stable and unstable injuries. Stable fractures can be treated non-operatively. The optimal immobilization device (cast vs. brace) for stable fractures is controversial. Presence of a posterior malleolar fracture often mandates the need for CT scanning. Intra-operative stability testing using fluoroscopy is needed to evaluate the necessity of syndesmosis screw fixation. The type of syndesmosis fixation (e.g., three vs. four-cortices) and the timing/need for screw removal is debatable. The post-operative rehabilitation regimen (early vs. late weight-bearing and timing for initiation of range of motion exercises) can vary. Optimal function is achieved as long as 1 year after treatment initiation. The long term outcome can vary depending not only on severity of the injury, the quality of fixation and restoration of ankle stability but also, on social and demographic factors. Frequent early complications include superficial peroneal nerve damage, infection, stiffness and painful hardware. Long term consequences are arthrofibrosis and osteoarthritis.

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Authors and Affiliations

  1. Frimley Park Hospital, Frimley, Portsmouth Road, Frimley, UK

    Nikolaos Gougoulias & Anthony Sakellariou

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  1. Nikolaos Gougoulias
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  2. Anthony Sakellariou
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Correspondence to Nikolaos Gougoulias .

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  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

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© 2014 EFORT

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Gougoulias, N., Sakellariou, A. (2014). Ankle Fractures. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_152

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  • DOI: https://doi.org/10.1007/978-3-642-34746-7_152

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-34745-0

  • Online ISBN: 978-3-642-34746-7

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