Management of Isolated Lateral Malleolus Fractures

被引:36
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
相关论文
共 50 条
[41]   Effect of mini-fragment fixation on the stabilization of medial malleolus fractures [J].
Amanatullah, Derek F. ;
McDonald, Erik ;
Shellito, Adam ;
Lafazan, Shain ;
Cortes, Alejandro ;
Curtiss, Shane ;
Wolinsky, Philip R. .
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, 2012, 72 (04) :948-953
[42]   Posterior malleolus fractures in Bosworth fracture-dislocations. A combination not to be missed [J].
Kostlivy, Karel ;
Bartonicek, Jan ;
Rammelt, Stefan .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2020, 51 (02) :537-541
[43]   A Novel Plate for Vertical Shear Fractures of the Medial Malleolus A Biomechanical Study [J].
Bektas, Yunus Emre ;
Ozmanevra, Ramadan ;
Cici, Hakan ;
Ciklacandir, Samet ;
Demirkiran, Nihat Demirhan ;
Isler, Yalcin ;
Basci, Onur ;
Erduran, Mehmet .
JOURNAL OF THE AMERICAN PODIATRIC MEDICAL ASSOCIATION, 2024, 114 (06)
[44]   The Value of Additional Gravity Stress Radiographs for Decision Making in the Treatment of Isolated Type B Distal Fibular Fractures [J].
van Leeuwen, Claar A. T. ;
van Dorst, Roderick W. J. J. ;
Krijnen, Pieta ;
Schipper, Inger B. ;
Hoogendoorn, Jochem M. .
FOOT & ANKLE INTERNATIONAL, 2021, 42 (08) :1031-1039
[45]   Isolated posterior malleolus fracture: A case report and review of the literature [J].
Otayek, Joeffroy ;
Ghanimeh, Joe ;
El Alam, Anthony ;
Mouawad, Joseph ;
Khoury, Alfred .
INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS, 2024, 125
[46]   Lateral Compression Fragility Fractures of the Pelvis: Diagnosis, Classifications, and Modern Management [J].
Patterson, Joseph T. ;
Parry, Joshua A. .
CURRENT OSTEOPOROSIS REPORTS, 2024, 22 (06) :621-631
[47]   Management of isolated volar lunate facet fractures of the distal radius [J].
Tuano, Krystle R. ;
Mudgal, Chaitanya S. .
JOURNAL OF ORTHOPAEDICS, 2024, 51 :46-53
[48]   Surgical Management of Isolated Greater Tuberosity Fractures of the Proximal Humerus [J].
DeBottis, Daniel ;
Anavian, Jack ;
Green, Andrew .
ORTHOPEDIC CLINICS OF NORTH AMERICA, 2014, 45 (02) :207-+
[49]   Therapeutic approach to combined deltoid ligament disruption with lateral malleolus fracture: Current evidence and literature review [J].
Nasrallah, Khalil ;
Haim, Shtarker ;
Einal, Bathish .
ORTHOPEDIC REVIEWS, 2021, 13 (01)
[50]   Repair of a lateral malleolus defect with a composite pedicled second metatarsal flap [J].
Chen, Huihao ;
Yin, Gang ;
Hou, Chunlin ;
Zhao, Liangyu ;
Lin, Haodong .
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH, 2018, 46 (12) :5291-5296