My Orthopedic Surgery

Discussion: - term pilon (hammer) fracture was introduced to describe these compression injuries by Destot in 1911; - fracture components: - combination of ankle fracture & distal tibial metaphyseal fracture, usually with intra articular comminution; - fracture of medial malleolus; - fracture of anterior margin of tibia; - transverse fracture of posterior tibial surface; - 20-25% of these will be open

Ankle Fracture Classification Weber A and B
Raymond White MD
OTA Basic Fracture Course

AONA posting of the AO Classification of Long Bone Fractures

Current Concepts
OTA Basic Fracture Course Edward W. Rutledge, MD

Talus Fractures
Keith Mayo
OTA Basic Fracture Course

Links to 32 topics relating to ankle fractures
Wheeless' Textbook of Orthopaedics

Includes short introduction, differentials, findings (including X-rays), and a bibliography. Free, but requires registration. Peer Reviewed eMedicine article.
Synonyms and related keywords: ankle fracture, broken ankle, fractured ankle, broken ankle bone, fractured ankle bone, fractured anklebone, broken anklebone, Ottawa ankle rules, broken foot, fractured foot, sprained ankle, twisted ankle

Illustrated Ankle Fracture classification

High energy intraarticular fractures of the distal tibia (tibial plafond fractures, or pilon fractures) present a great challenge to the orthopaedic surgeon. These injuries often result in a significant soft tissue damage, comminution of bone, and disruption of the articular cartilage and subchondral bone. The treatment strategy used in dealing with tibial plafond fractures is strongly influenced by the often-precarious soft tissue conditions. Due to the great treatment challenges posed by this high-energy injury, there has been much controversy about the most appropriate and best treatment for tibial plafond fractures. Factors such as timing of treatment, method of stabilization, techniques of operative care, and postoperative rehabilitation have all been hotly debated and, at times, contested by various orthopaedists. This chapter will attempt to comprehensively address the anatomy, physiology, and diagnosis of this injury; it will also discuss various treatment modalities, and the importance of tailoring treatment to the extent of the bony and soft tissue injuries.

a proximal fracture of fibula resulting from external rotation
Injury may occur with medial malleolus avulsion fracture or deltoid ligament rupture, rupture of anterior talofibular ligament or avulsion of its insertion, as well as rupture of interosseous ligament, rupture of posterior tibiofibular ligament, or posterior malleolar fracture
Wheeless' Textbook of Orthopaedics

Archive Copy 2004: University of Alabama Trauma Protocol

Syndesmotic Injuries of the Ankle
syndesmosis is made up of anterior-inferior tibiofibular ligament, interosseous ligament, and posterior-inferior fibular ligaments, inferior transverse tibiofibular ligament, and interosseous ligament;
- these stabilize the mortise by opposing the fibula in the fibular notch (incisura fibularis tibiae);
- section of the anterior tibiofibular ligament results in diastasis of 2.3 mm;
- section of anterior tibiofibular ligament and interosseous ligament will result in diastasis of 4.5 mm;
- when all 3 ligaments are sectioned, diastasis measures 7.3 mm; Wheeless' Textbook of Orthopaedics

This module shows step-by-step descriptions of

• Diagnosis
• Patient preparation
• Approaches
• Reduction & fixation
• Aftercare

 
for all malleolar fractures of the AO classification system.
In addition, there are videos, animations, journal articles and book chapters.
 
Authored by Paulo Barbosa, Felix Bonnaire, Kodi Kojima, Executive editor: Chris Colton

Salter Harris III fracture involving avulsion of anterolateral tibial epiphysis;
- occurs in older adolescents, after the middle and medial parts of epiphyseal plate has closed, but before the lateral part closes (usually 12 to 15 yrs of age);
- because, this fracture occurs in adolescents witj relatively mature growth plates, there is minimal potential for deformity due to growth plate injury
- note that the common triplane fracture will contain a tillaux fracture in addition to the tibial physeal fracture
Wheeless' Textbook of Orthopaedics

Trimalleolar Fracture: (Cotton Fracture)
involves fractures of medial malleolus & fibula, along with fracture of posterior lip of articular surface of tibia
Wheeless' Textbook of Orthopaedics