Management of Isolated Lateral Malleolus Fractures

被引:31
作者
Aiyer, Amiethab A. [1 ]
Zachwieja, Erik C. [1 ]
Lawrie, Charles M. [2 ]
Kaplan, Onathan R. M. [3 ]
机构
[1] Univ Miami Hosp, Dept Orthopaed Surg, Miami, FL 33136 USA
[2] Washington Univ, Dept Orthopaed Surg, Sch Med, St Louis, MO USA
[3] Orthopaed Specialty Inst, Orange, CA USA
关键词
LAUGE-HANSEN CLASSIFICATION; MEDIAL CLEAR SPACE; DELTOID LIGAMENT INTEGRITY; B ANKLE FRACTURES; OPERATIVE TREATMENT; STRESS RADIOGRAPHS; FIBULAR NAIL; DISTAL FIBULA; FIXATION; STABILITY;
D O I
10.5435/JAAOS-D-17-00417
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Isolated lateral malleolus fractures represent one of the most common injuries encountered by orthopaedic surgeons. Nevertheless, appropriate diagnosis and management of these injuries are not clearly understood. Ankle stability is maintained by ligamentous and bony anatomy. The deep deltoid ligament is considered the primary stabilizer of the ankle. In the setting of an isolated lateral malleolus fracture, identifying injury to this ligament and associated ankle instability influences management. The most effective methods for assessing tibiotalar instability include stress and weight-bearing radiographs. Clinical examination findings are important but less reliable. Advanced imaging may not be accurate for guiding management. If the ankle is stable, nonsurgical management produces excellent outcomes. In the case that clinical/radiographic findings are indicative of ankle instability, surgical fixation options include lateral or posterolateral plating or intramedullary fixation. Locking plates and small or minifragment fixation are important adjuncts for the surgeon to consider based on individual patient needs.
引用
收藏
页码:50 / 59
页数:10
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