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#Trimalleolar fx full
#Trimalleolar fx series

#Trimalleolar fx full

Many specialists prefer weight-bearing views, which may be very useful however, patients with severe foot and ankle injuries may have problems weight-bearing.The operative goal in the treatment of ankle fractures is well established: to restore anatomy and stability for early movement and full functional recovery, and prevent post-traumatic arthritis. In addition, a malunion in the anatomical relationship may indicate an old fracture (it is also necessary to look for bony sclerosis). An increase in the space between the talus and the surrounding fibula or tibia 5 mm or more is suspicious for a complete disruption of the lateral or medial collateral ligament. These views place an anatomical load on the ankle mortise. Stress views: usually obtained by specialists.Osteochondritis dissecans should be suspected in any patient who complains of joint locking or joint mice.

This latter condition appears as a minute semioval (saucer-shaped) bite mark along the joint line. Uses include detection of pilon fractures of the distal tibia or fractures of the talar dome as well as osteochondritis dissecans of the tibiotalar joint.

#Trimalleolar fx series

It may be used as part of acute trauma series for high-impact injuries. A mortise view eliminates the overlap of the distal fibula and tibia seen on routine AP projections and allows for better visualization of the talar dome and the distal tibia (plafond).

Mortise view: the ankle is rotated internally 10 to 15 degrees.

Additional tests to order include the following:

Difficulty weight-bearing with an inability to take four steps.Īnteroposterior (AP), lateral, and oblique views should be ordered.

It is essential to document the neurovascular examination carefully.

Determine whether there is neurovascular impairment (cold, cyanotic limb with diminished or absent pulses, impaired sensation).

Inspect for heel pain (calcaneal fracture).

Palpate the fifth metatarsal for an associated metatarsal fracture, the navicular for focal tenderness for possible fracture, and the talus (check for talar pain with ankle dorsiflexion) for an associated talar fracture.

Check for tenderness along the posterior edge of the tibia posterior tibia (posterior tibial fracture).

Perform the anterior and posterior drawer tests to check for ankle instability.

However, the presence of a distal tibial fracture or a disrupted deltoid ligament (marked swelling 5 mm or greater between the talus and the distal tibia) should prompt the examiner to search for a fracture of the distal fibula or torn lateral collateral ligaments. Pain, swelling, and tenderness along either or both malleoli may be secondary to an acute fracture or a severe ankle sprain. Eversion injuries are less common, but they are more likely to result in unstable fractures. In addition, the lateral collateral ligaments (the anterior and posterior talofibular ligaments and the posterior talofibular ligament) are thinner than the stronger broad-based medial collateral (deltoid) ligament. The non–weight-bearing distal fibula is thinner than the distal tibia.

The mechanism of injury is direct impact caused by inversion or eversion injuries. Patients complain of marked pain, swelling, and tenderness associated with an inability to bear weight or ambulate. About one-third of all ankle fractures are bimalleolar and trimalleolar fractures.īimalleolar and trimalleolar fractures account for more than 30% of all ankle fractures.Trimalleolar fractures are fractures of the distal fibula, tibia, and the posterior lip of the distal tibia.Bimalleolar fractures are fractures of the distal fibula and tibia.