Ankle fractures

Ankle injuries, especially malleolar fractures, are quite common. The outcome of their treatment depends on the correct identification of the mechanism of injury and subsequent realignment of the ankle fracture with appropriate fixation. The diagnosis of an ankle fracture can be made on the initial radiographs and when there is only one break of the ring of the ankle mortice, without significant displacement, then non-operative treatment can be appropriate. A double break of the ankle mortice ring with displacement and tibiofibular disruption requires open reduction and internal fixation. Whatever technique is used it should result in a stable fixation and complete congruency of the ankle joint mortice and should allow early rehabilitation. Pronation or type C Weber ankle fractures and piton fractures are associated with a lower outcome score whilst supination-eversion fractures of the Lauge-Hansen classification are characterised by less displacement and fewer complications. (C) 2004 Elsevier Ltd. All rights reserved.