Open reduction and internal fixation (ORIF) is often required in ankle fractures to achieve stable anatomical reduction of the talus within the ankle mortise. Weber A fractures or Weber B fractures without talar shift.Non-displaced medial malleolus fractures.Request a repeat plain film radiography if the reduction is not adequate, repeat reduction attempts are required.Ĭonservative management will often be opted for in: You must then repeat and document the post-reduction neurovascular examination. Once reduced, the ankle should be placed in a below knee back slab. Any patients that have with evidence of an open fracture should be managed accordingly. Initial management requires immediate fracture reduction, usually performed under sedation in the Emergency Department, to realign the fracture to anatomical alignment. This system is based on the ankle position at the time of injury and the deforming force involved, and is much more detailed than the Weber classification. In orthopaedic practice, the Lauge-Hansen classification is more widely used. The more proximal the injury, the higher the likelihood of ankle instability consequently, Type C fractures almost always need surgical fixation. Type C = above the level of the syndesmosis.Type B = at the level of the syndesmosis.The most common classification used, especially within the Emergency Department, is the Weber classification, which classifies lateral malleolus fractures: Crudely, they can be described as isolated lateral malleolar fractures, isolated medial malleolar fractures, bimalleolar fractures ( = medial + lateral malleolar fracture), and trimalleolar fractures ( = medial + lateral + posterior malleolar fracture). Figure 1 – The ankle is comprised of the tibia, fibula, and talus ClassificationĪnkle fractures can be described anatomically.
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