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Ankle fracture

Last updated: May 26, 2020

Summary

Ankle fractures are the most common fractures of the lower extremity. They are most often caused by twisting the ankle, the circumstances of which the patient will typically recall. The major symptoms are pain in the affected area and decreased range of motion. If physical examination and the patient history suggest a fracture (e.g., patient is unable to bear weight on the affected leg), an x-ray is performed. The most important diagnostic consideration is whether the fracture is stable (as is the case in isolated malleolar fractures) or unstable (e.g., bimalleolar fracture). Unstable fractures require surgery, whereas stable fractures can be treated conservatively with a short leg cast.

Etiology

References:[1]

Classification

Fracture Stability
  • Usually stable
  • Usually unstable, as often associated with other malleolar fractures
  • Mostly unstable
  • Always unstable

Weber classification of ankle fractures

The Weber classification categorizes ankle fractures according to the level of the fibular fracture in relation to the ankle syndesmosis (tibiofibular syndesmosis).[2]

Clinical features

Diagnostics

References:[4]

Treatment

References:[4]

Complications

References:[5][6]

We list the most important complications. The selection is not exhaustive.

References

  1. Dähnert W. Radiology Review Manual. Lippincott Williams & Wilkins ; 2011
  2. Weber classification of ankle fractures. https://radiopaedia.org/articles/weber-classification-of-ankle-fractures. Updated: January 1, 2016. Accessed: December 8, 2016.
  3. Maisonneuve fracture. https://radiopaedia.org/articles/maisonneuve-fracture. Updated: January 1, 2016. Accessed: December 8, 2016.
  4. Neumaier Probst E, Maas R, Meenen NM. Isolated Fracture of the posterolateral tibial lip (Volkmanns's triangle). Acta Radiologica. 1997; 38 (3): p.359-362. doi: 10.1080/02841859709172083 . | Open in Read by QxMD
  5. Pilon Fractures of the Ankle. http://orthoinfo.aaos.org/topic.cfm?topic=A00527. Updated: November 1, 2015. Accessed: December 8, 2016.
  6. Panchbhavi VK, Johnson AE. Pilon Fractures. Pilon Fractures. New York, NY: WebMD. http://emedicine.medscape.com/article/1233429-clinical. Updated: April 15, 2016. Accessed: December 8, 2016.
  7. Koehler SM, Eiff P, Fields KB, Grayzel J. Overview of ankle fractures in adults. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/overview-of-ankle-fractures-in-adults?source=search_result&search=ankle%20fracture&selectedTitle=1~46.Last updated: December 2, 2016. Accessed: October 8, 2016.
  8. Rutkove SB, Shefner JM, Dashe JF. Overview of lower extremity peripheral nerve syndromes. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/overview-of-lower-extremity-peripheral-nerve-syndromes?source=see_link§ionName=PERONEAL%20NERVE&anchor=H21#H21.Last updated: December 14, 2014. Accessed: December 8, 2016.
  9. Iskyan K, Mills TJ. Ankle Fracture. Ankle Fracture. New York, NY: WebMD. http://emedicine.medscape.com/article/824224-clinical#showall. Updated: October 26, 2016. Accessed: December 8, 2016.
  10. Ankle radiograph (an approach). https://radiopaedia.org/articles/ankle-radiograph-an-approach. Updated: January 1, 2016. Accessed: December 8, 2016.