The results of Michelson et al., Jain et al., Wykes et al. This involves strengthening and mobility exercises of the foot and ankle. 1). Non-surgical and surgical Emilia Mller Rydberg. All rights reserved. ment is considered the primary stabilizer of the ankle. This results in a small, often unstable fragment. Lateral malleolus fractures cause 1. During this period, Physical Therapy can begin to maintain the mobility of the surrounding tissues, such as the Calf, Peroneal, and Posterior Tibialis muscles. Cookies policy. 2017. II. The study was approved by the Regional Ethical Review Board, Gothenburg (Reference number: 101115). Foot Ankle Int. As suggested by Michelson et al. This is often an ORIF involving Wennergren D, Ekholm C, Sandelin A, Moller M. The Swedish fracture register: 103,000 fractures registered. Conservative treatment of Medial Malleolus Fractures requires 4-6 weeks in a walker boot. Recovery time in posterior malleolus fracture varies from person to person and depends on the type and severity of the injury and the overall health of the person. new, unexplained systems develop Sports Medicine: Lateral Malleolus Avulsion Fractures Most believe that if they can wiggle their toes or move the ankle around that an ankle fracture has not occurred. Ann R Coll Surg Engl. Elevation: Elevation is important to keep swelling restricted. They produced an algorithm based on stability to be used in decision-making to find the appropriate method of treatment for ankle fractures. Springer Nature. Since this fact determines whether the fracture is a stable B1 fracture or an unstable B2 fracture, it affects both the treatment of choice and the reliability of the fracture classification. Ankle. According to the preoperative physical examination described in the medical records, medial tenderness was found in 73 (24%) of the non-surgically treated patients and in 77 (25%) there was no comment on medial tenderness in the medical charts. Twoyears were studied and the results are not affected by seasonal variations. During this period, you can commence Physical Therapy to assist with mobilisation, isometric strengthening exercises and soft tissue work to maintain flexibility in the ankle joint muscles. Ignoring treatment, including excessive movement of the ankle through unnecessary walking, leads to a greater risk of worsening the injury. exclude stress fracture. Further investigations such as an MRI, CT scan or bone scan may be required, in some cases, to assist with diagnosis and assess the severity of the injury. The most common site for stress fractures in the lower extremity is the distal third of the tibia; Yes. Tibialis posterior tendinosis, which is degeneration of the tibialis posterior tendon, and tibialis posterior tenosynovitis are the most common causes of pain behind the medial malleolus. Make certain The medial malleolus is the medial projection of bone from the distal tibia. The calcaneofibular ligament will be hypoechoic and thickened or swollen in case of a sprain. 2012;83(3):27681. The more severe, bimalleolar fractures tend to affect young men, whereas the unimalleolar fractures affect the older age group and predominantly women. Epidemiology. Open access funding provided by University of Gothenburg. BMC Musculoskelet Disord. Despite the fact that its been shown that medial tenderness, brusing or ecchymosis are unreliable predictors of medial ligament injury these are the signs used in clinical practice today. 2016;47(2):47882. %PDF-1.5 EMR conducted the study and the statistical calculations, created the figures and tables, analysed data and wrote the final draft of the manuscript. This probably reflects a lack of understanding of the classification of ankle fractures. Types of soft tissue treatment: Myofascial release: Fascia is bands of connective tissue that covers and supports all structures in the body including bones, nerves, muscles, tendons and organs. Yes. Lateral Malleolus Fractures are generally stable fractures but traumatic events such as a fall or trip can lead to an unstable fracture. Comminuted medial malleolus fractures can be technically challenging injuries to treat given the limited surface area by which a surgeon can reconstruct the bone fragments. Among the 439 patients registered with B1 fractures, 309 patients (70%) were treated non-surgically and 130 (30%) surgically. Plain radiographs may show a lateral malleolar tip or avulsion fracture other findings include lateral malleolar soft tissue swelling. J Bone Joint Surg Br. None of the non-surgically treated patients had late displacement or needed surgical treatment during the 2-year follow-up period. In addition to the observational data from the SFR, medical records and radiographs were reviewed for all patients registered with an AO/OTA 44 B1 fracture (Fig. I saw an ortho ankle specialist this week who told me the avulsion fracture would never heal as it was just too tiny (2mm x 12mm he said) However as it is non Historically a cast was used, but the walker boot allows for greater function and equivalent healing response. Required fields are marked *. 2019 All patients were informed at registration in the Swedish Fracture Register that they had the right to withdraw. Google Scholar. Complex open fractures with soft-tissue injuries have a worse prognosis than isolated closed ankle fractures. and the current study further support the hypothesis that, with the right guidelines strictly to distinguish stable from unstable ankle fractures, the stable fractures can be successfully treated non-surgically, with full weight-bearing allowed and with no need for follow-up radiographs. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. We recommend a consultation with a medical professional such as James McCormack. Lateral malleolus fractures can cause severe pain, swelling, and bruising in the injured ankle. There are two condyles on each leg known as the medial and lateral femoral condyles. Injury of the posterior inferior tibiofibular ligament or avulsion of the posterior malleolus Pronation abduction (PA) 1. studied the epidemiology of ankle fractures in Sweden between 1987 and 2004 but there is a lack of up to date epidemiological studies on ankle fractures [7]. The results of the study reveal the application of the AO/OTA classification and real-life treatment algorithms. J Trauma. Age: 32 Sex: male Height: 511 Weight: 160lbs Race: cacausian Duration of complaint: 1 week Location: ankle (lateral malleolus) Any existing relevant medical issues: no Current medications: None. found that non-surgically treated patients had less pain and a better functional score compared with surgically treated patients [19]. . Primary and late results of operative and non-operative treatment. The aim of this study was to describe the epidemiology of ankle fractures treated at Sahlgrenska University Hospital (SU) during a 2-year period and analyze the current diagnostic process, classification and choice of treatment for lateral malleolar fractures at the level of the syndesmosis. The study included 1332 ankle fractures. stream TZ planned and conducted the study, analysed data and revised the manuscript. These two forces exert tension on the deltoid ligament, causing an avulsion of the tip of the medial malleolus or a rupture of the deltoid ligament. Treatment may comprise: soft tissue massage joint mobilization electrotherapy (e.g. California Privacy Statement, The difference in immobilization time corresponds well to the average 4.6days that the surgically treated patients had to wait for their surgery. Nonsurgical Care During the 2 consecutive years from 1 April 2012 and 31 March 2014, 1328 patients with ankle fractures were treated at SU. The fibula is the smaller of the two shin bones on the outside of the lower leg. Combined experimental-surgical and experimental-roentgenologic investigations. The hard outer layer of bones is composed of cortical bone, which is also called compact bone as it is much denser than cancellous bone. In most cases, people return to normal daily activities within 3 to 4 months. For all patients registered at Sahlgrenska University Hospital (SU) with an ankle fracture between 1 April 2012 and 31 March 2014, data were collected from the SFR. J Orthop Trauma. Ankle sprains are common musculoskeletal injuries that can occur from playing sports or from everyday activities. You may walk on the foot as comfort allows although you will find it easier to walk with crutches in the early stages. Pakarinen HJ et al. If you have pain in other areas of the foot and ankle, you may have a more serious ankle injury. It usually follows a pattern of being painful with all weight bear activities, unlike a tendon injury that may improve during an activity. J Bone Joint Surg Br. WebDuring surgery to treat this Tillaux fracture, the bone fragments have been set into alignment and held together with a screw fixation. The datasets used and analysed during the current study are available from the corresponding author on reasonable request. The decision regarding which trans syndesmotic ankle fractures to treat surgically and which to treat non-surgically is a matter of debate. 1950;60(5):95785. 47% of the fractures were caused by a fall on the same level due to slipping, tripping or stumbling. This is a complex fracture involving multiple structures and requires extensive surgery for recovery. In general, it takes at least 6 weeks for the broken malleolus to heal. The three aforementioned parts of bone articulate with the talus bone of the foot. During the treatment and follow-up period, the mean total number of radiographs performed for non-surgically treated patients were 2.2, compared with 2.9 in the surgically treated group. This would minimize the likelihood of patients being exposed to the risks of surgery with a fracture that could just as well be treated non-surgically. The medial malleolus is the bony prominence on the inner aspect of your ankle joint, at the bottom of the tibia. Stable: a single fracture of the pelvis; Unstable: the pelvis has fractured in more than one place; Transverse: directly across the bone; Oblique: a fracture at an angle; Spiral: a twisting fracture; Comminuted: the bone is broken into many pieces; Greenstick: found in young children when the bone bends on one side and breaks on the other Fibula fracture. The average number of days of immobilization in a plaster or a brace were 46 for the surgically treated patients compared with 43days for non-surgically treated patients. 2009;129(2):22735. Swedish Fracture Register. A considerable number of these patients with medial tenderness, especially the ones where the responsible physician decided to treat surgically, can be suspected of having had a medial ligament injury and were not classified correctly. The medical records of the patients that had initially been assigned to non-surgical treatment but had been changed to surgical treatment at an early stage were additionally studied to ascertain why the treatment strategy had been changed. weak core muscles. In addition, 2 of the non-surgically treated patients were treated surgically at a later stage due to non-union. ultrasound) ice or heat treatment ankle taping or ankle bracing the In the current study of non-surgically treated B1 fractures, the follow-up radiographic examination at 1week changed the treatment plan correctly in only 3 cases (<1%). ; The inferior tibiofibular articulation (tibiofibular syndesmosis) is formed by the rough, convex surface The most common cause of injury was a fall on the same level due to slipping, tipping or stumbling (47%) for all ankle fractures, as well as for all subtypes respectively. Michelson JD, Ahn U, Magid D. Economic analysis of roentgenogram use in the closed treatment of stable ankle fractures. Do we gain weight if we sleep in the afternoon? Keep weight off the ankle until it has healed, and The inflamed tissue needs time to heal, and walking on it too soon may cause more damage. [1] During a Supination-Adduction injury, the Peroneus Brevis tendon could be injured and could possible pull at the base of the 5th Metatarsal causing an avulsion fracture known as a Jones Fracture . 2`Bqz J)BLk9@17{rNsTr3 Acta Orthop. Fracture of the Lateral Malleolus of the Tibia in Horses. Injury. WebNew radiographic projections for avulsion fractures of the lateral malleolus. The failure of bone most commonly results from an acute event with the application of usually sudden, tensile force to the bone through the soft In the vast majority of cases (97%), plain radiographs were the only radiographic imaging modality used. BMC Musculoskelet Disord 21, 521 (2020). The Swedish Fracture Register (SFR) is a national quality register that collects data on all types of fracture regarding cause of injury, type of fracture, given treatment, and subsequent treatment results [1]. k _~bwL8_? endobj Wennergren D, Stjernstrom S, Moller M, Sundfeldt M, Ekholm C. Validity of humerus fracture classification in the Swedish fracture register. 1). Pakarinen HJ, Flinkkil TE, Ohtonen PP, Ristiniemi JY. Of these, 512 were classified as B1 fractures, of which 439 were both initially treated and followed up at SU and were included in the detailed study. It facilitates bone's main functionsto support the whole Part of Evaluation of the Deltoid Complex in Supination External Rotation Ankle Fractures. Treatment is generally nonoperative with NSAIDs, rest and activity modifications. J Orthop Trauma. . If your fracture is stable and your joints are well-aligned, surgery may not be necessary. For the remaining 73 patients initial treatment or follow up was conducted at another hospital or medical records was not found or could not be accessed therefore they were not included in the study (Fig. Physical Therapy rehabilitation will become progressively more challenging with stability, balance and strengthening exercises. Treatment for a fibula fracture can vary and depends greatly on how severe the break is. WebMedial Malleolus Fracture Treatment Conservative treatment of Medial Malleolus Fractures requires 4-6 weeks in a walker boot. Comminuted fractures of the medial malleolus are generally high-energy injuries that break the bone into multiple pieces. These fractures oft indicate syndesmotic injury and may be the only boney deformity present. Improvement in the treatment of stable ankle fractures: an audit based approach. This will also help to minimize pain because it holds your ankle in From the medical records information regarding signs of medial ligament injuries found at the initial physical examination was obtained as well as instructions regarding weight bearing restrictions and immobilization period. This is part of the fibula bone on the outside of the lower leg. Jain N et al. Rydberg, E.M., Zorko, T., Sundfeldt, M. et al. Only registered members can ask a question, but you do not need to register to respond and give help. Since the two fracture types might appear similar on plain radiographs, the physical examination of the patient is a crucial part in the decision-making regarding treatment method. The classification of malleolar fractures, as well as treatment of them, is a matter of debate. All authors have given final approval of the version to be published. Sieloff et al. Concurrent medial and lateral malleolar fractures, osteochondral injuries of the talus, lateral ligament, syndesmotic ligament, and spring ligament injuries, and tibialis posterior pathology are well depicted on a combination of sagittal, coronal, and axial images utilizing T1-, intermediate-, and T2-weighting. In contrast to this, in the current study, 130 patients (30%) classified as having sustained a B1 fracture were treated surgically. This is where the ligament is pulled off the bone and in doing so it can pull some flakes or fragments of the bone off with it. If there is a fracture (break) in part of the condyle, this is known as a fracture of the femoral condyle. This could be interpreted as either indicating that the finding of medial tenderness was not equal to a significant structural medial ligament injury or that some B2 fractures can be treated non-surgically. We wish to thank all the orthopaedic surgeons at the affiliated departments for entering detailed data to the register. Lateral malleolus fracture Firstly, the surgeon will realign the bone fragments, returning them to their original position. WebThe symptoms of a medial malleolus fracture are fairly predictable: Pain on the inner side of the ankle, swelling and bruising, and difficulty walking. WebWhen the avulsion fracture occurs, immediately wrap your ankle with a compression wrap or elastic bandage. Wang Q. et al. Treatment for a Lateral Malleolus Fracture. The peroneal tendons pass down the back and underneath the lateral malleolus. Overuse causes the peroneal tendons to rub on the bone and become inflamed. The peroneus longus tendon runs around the back of the lateral malleolus and under the foot. If you have suffered an avulsion foot fracture, contact us today at 888-804-5044 to speak with an avulsion injury lawyer and to learn your options. Elsevier Health Sciences, 2008. An MRI can provide more detailed information on a bony injury and soft tissue structures such as ligaments and tendons. On the other hand, of all the B1 fractures treated non-surgically, despite having medial tenderness, in only 1 case the treatment was changed to surgical at an early stage. Can you cancel when multiplying fractions? The reason. Among the surgically treated patients 18% (n=24) were found to have no medial tenderness. When this part of the bone fractures, or breaks, it's called a lateral malleolar fracture. If your ankle hurts or is tender to the touch directly over the ankle bone, you probably have a fracture While a slight sprain may allow you to limp, most people wont be able to walk without severe pain if the ankle is broken. A CT Scan will give the most detailed information on a fracture and is often used to establish the severity of a fracture. In more severe cases, the bone may be broken into several fragments, known as a comminuted fracture. He offers. WebFractures Avulsion fractures are breaks or splits in the bone. The Incidence of Complications Following Scarf Osteotomy for the Treatment of Hallux Valgus: A Systematic Review with Meta-Analysis. Injury of the anterior inferior tibiofibular ligament 3. Of the patients with C2 fractures, 75% were women and their mean age was 57years, whereas the men in the same group had a mean age of 38years (Table 1). Post-operative complications include nerve damage if a nerve is cut during the procedure, but these surgeries are generally very successful overall. differentiate from stress fracture, which shows "dreaded black line" 3-phase bone scan. In the setting of an isolated lateral malleolus fracture, identifying injury to this ligament and associated ankle instability influences management. WebThe lateral malleolus can fracture at a number of different levels, and treatment often depends on where the fracture is located. Manage cookies/Do not sell my data we use in the preference centre. In the A2 group, 19% of the fractures were due to high-energy trauma and 8% of the C2 group were open fractures (Table 1). An x-ray is the primary imaging model, but if this returns, as usual, a referral for an MRI or Ct Scan may be required. Observational data regarding all ankle fractures treated at SU between 1 April 2012 and 31 March 2014 was collected from the Swedish Fracture Register. Save my name, email, and website in this browser for the next time I comment. The most commonly affected age group was 5665years. 2018;49(11):206874. A hairline fracture is Article Descriptive statistical analyses and the building of charts were executed in Excel 2013. Classification and treatment of lateral malleolar fractures - a single-center analysis of 439 ankle fractures using the Swedish Fracture Register, https://doi.org/10.1186/s12891-020-03542-5, https://link.springer.com/book/10.1007%2F978-3-642-61261-9, https://doi.org/10.3827/faoj.2010.0304.0001, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, bmcmusculoskeletaldisorders@biomedcentral.com. 2009;91(5):10429. There is an apparent difficulty in clinically determining whether or not a lateral malleolar fracture has an associated injury to the medial ligament. The symptoms of Medial Malleolus Fractures can vary depending on the type and severity of the break. Radiographs were reviewed in cases were treatment deviated from standard care to make sure the fracture classification was correct. SooHoo NF, Krenek L, Eagan MJ, Gurbani B, Ko CY, Zingmond DS. This is not medical advice. Annual Report 2016. Ultrasound is becoming a more favored diagnostic imaging tool as it can assess the peroneal tendons in a dynamic environment. The lateral malleolus is treated with a plate and screws as usual. 1980;51(6):98190. 69 (6), 2010, 1515-22. If a lateral malleolar fracture is classified as B1, despite having an injury to the medial structures, and undergoes surgical treatment, there is clearly a lack of understanding of the AO/OTA-fracture classification but a possible correct treatment. 3 0 obj pes planus. The posterior tibial tendon lies immediately behind the medial malleolus. If weight bearing (WB) is too painful, the patient can be given elbow crutches and be non-weight bearing (NWB) for 24 hours. Webafter several months, please phone the fracture clinic helpline as listed below for further advice. 38 had an avulsion fracture, and the rest showed ligamentous injury or bony contusion. If the broken bone is not out of place and the ankle is stable, treatment may consist of just wearing a special boot or cast to immobilize the ankle as it heals. The current study demonstrates the difficulty involved in distinguishing whether or not a trans-syndesmotic lateral malleolar fracture has an associated medial ligament injury or not. MRI can show the static anatomy of the peroneal tendons. We recommend a consultation with a medical professional such as James McCormack. 2012;26(3):12934. WebA lateral malleolus fracture can happen at several different levels. (Right) Surgical repair of a medial malleolus fracture with a plate and screws. Where are you experiencing pain? MM planned and conducted the study and revised the manuscript. For identified AO/OTA44-B1 fractures, medical records and radiographs were reviewed and analyzed. This pattern was also seen for most of the individual fracture classes with the exception of the groups of A3 and C3 fractures where there were substantially more men than women (A3 men: women 65:35 and C3 men: women 76:24) (Table1). indications. According to the AO/OTA classification, a trans-syndesmotic fracture of the lateral malleolus, combined with a rupture of the medial ligament, is a 44B2 fracture. Lateral malleolar fractures at the level of the syndesmosis, AO/OTA 44 B fractures, are the fourth most common fracture registered in the SFR and are commonly referred to as the equivalent of Lauge-Hansen supination-external rotation (SER) injuries [8, 9] (Fig. 80 (4), 1998, 684-8. 838 (63%) were B-fractures and 512 (38%) of these were B1 fractures. When a child twists their ankle, the medial malleolus can fracture. If the broken bone is not out of place and the ankle is stable, treatment may consist of just wearing a special boot or cast to immobilize the ankle as it heals. The treatment plan was based on common knowledge in the field and the decision to treat surgically or not was made by the attending surgeon. Walking in the boot for short distances is allowed, but pain levels should dictate it. You can have pain and swelling on the inner side of the ankle in addition to the lateral malleolus fracture. Cases are typically worth more if the fracture extends into the ankle joint. Minimally invasive treatment of calcaneal fracture by percutaneous leverage, anatomical plate, and compression bolts : the clinical evaluation of cohort of 156 patient. The total mean age was 53years, with a slightly higher mean age among the women (men: women 49:56). <> BMC Musculoskelet Disord. Both a lateral malleolar fracture without an impaired deltoid ligament (SER-II or B1) and the combination of a lateral malleolar fracture with a deltoid ligament rupture (SER-IV or B2) appear as unimalleolar on plain radiographs (Fig. This is done to reduce the risk of the fracture not healing (called a nonunion), and to allow you to start moving the ankle earlier. 27% of the surgically treated patients had outpatient surgery with discharge the same day. The study further suggests that there is no need to check non-surgically treated stable fractures with follow-up radiographic examination at 1week. Appointments 216.444.2606. In some cases, surgery may be considered even if the fracture is not out of place. This is when a gap appears in the bone at the site of the fracture and these often require surgical repair, This is a type of fracture involving the growth plate and is common in children. Non-surgical and surgical options exist to treat medial malleolus fractures, but the choice often comes down to the extent of the fracture. Medial malleolus fracture or injury to the deltoid ligament 2. A consultation with a Physical Therapist, Podiatrist, or Sports Medicine Doctor is recommended if you have any of the symptoms of a Lateral Malleolus Fracture. A fracture of the medial malleolus is an injury to the bone on the inner side of the ankle. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Fatigue fractures are common in athletes, An ankle fracture is a break of one or more of the bones that make up the ankle joint. An analysis of data from the SFR relating to fracture classification, age, sex, cause of injury, frequency of high/low-energy trauma and frequency of closed/open fracture was conducted. Arch Surg (Chicago, Ill : 1920). For all of the non-surgically treated patients, the treatment was converted to surgical treatment at an early stage in 5 patients (1%). 4 0 obj With a bimalleolar fracture, bones on both the inner and outer side of the ankle are injured. However, since this is Swedens largest orthopedic center, with a primary catchment area of approximately 600,000 inhabitants, we believe that it is representative of the population of Sweden. A pathological fracture, although a type of insufficiency fracture, is a term in general reserved for fractures occurring at the site of a focal bony abnormality.Some authors use the term stress fracture synonymously with fatigue fracture, and thus some caution with the term is suggested.. This is usually followed by imaging to rule out other conditions and to confirm the diagnosis. In the current study, 79% of the surgically treated B1 patients and 50% of the non-surgically treated patients had some kind of weight-bearing restriction in addition to immobilization. In SFR ankle fractures are classified according to the Arbeitsgemeinschaft fr Osteosynthesefragen (AO)/Orthopaedic Trauma Association (OTA) classification [15, 16] (Fig. Juto H, Moller M, Wennergren D, Edin K, Apelqvist I, Morberg P. Substantial accuracy of fracture classification in the Swedish fracture Register: evaluation of AO/OTA-classification in 152 ankle fractures. #Qax d'I,(!+ h\rcB~ltIEHYLm}Yd M31%+D~WJg"+X-k>-/lQik Trauma such as a tackle in a sport, a trip or a fall can also lead to Medial Malleolus Fractures. Welcome to the Foot Health Forum community where you can ask about foot problems and get help, as well as be up-to-date with the latest foot health information. The strengths of the current study are that it includes a large number of consecutive patients where data were collected prospectively. Another limitation of the current study is that it only includes patients treated at Sahlgrenska University Hospital. Appointments & Locations. The most common site for stress fractures in the lower extremity is the distal third of the tibia; stress fractures of the medial malleolus are rare, accounting for 0.6% to 4.1% of all stress fractures. The SFR provides a unique opportunity to study the epidemiology of fractures [6]. The Weber ankle fracture classification (or Danis-Weber classification) is a simple system for classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint, specifically the distal tibiofibular syndesmosis.It has a role in determining treatment. Clinical signs like medial tenderness, ecchymosis and swelling are commonly considered, as well as tests for stability like the external rotation test [17] or stress gravity radiographs [18]. A Medial Malleolus Oblique Fracture usually results from a rotational injury and often involves the fibula bone or other structures, such as an Achilles Tendon rupture. 2012;94(22):204752. Consequently, by definition, a 44B1 fracture has no significant rupture of the medial ligaments. In the study population comprising all ankle fractures, the median age was 55years (1698) and the men had a mean age of 47years and the women 57years. For unstable Lateral Malleolus Fractures or a malunion, surgery may be required. May 8). Walking and running are often painful, with pain easing when non-weight bearing. For specific medical advice, diagnoses, and treatment, consult your doctor. WebOn lateral X-rays the fracture line was clearly seen from Medial malleolus around 21.5 21.5 relating to the management and the efficacy of treatment of avulsion fracture. . Foot Ankle Online J. This normally takes approximately 6 weeks to unite (heal) although pain and swelling can be ongoing for 3 to 6 months. MRI. . With a chip or avulsion fracture, once you have a walking cast or boot, you may be able to put pressure on the foot after a day or two, depending on your pain level. We found that ankle fractures are common in all age groups and both sexes. Ankle fractures: supination-eversion fractures of stage IV. Epidemiology. With a lateral ankle sprain, it is possible that the Peroneus Brevis can tear and cause swelling at the lateral ankle. Arbeitsgemeinschaft fr Osteosynthesefragen. On the whole, there usually is pain inside the ankle with swelling and bruising. The lateral malleolus sits on the outside of the ankle joint and absorbs approximately 10% of your weight in standing. It has been reported that the inci-dence of avulsion fractures of the lateral malleolus ranges from 12 to 34%, even as high as 46.5% in some studies [ 5]. Correspondence to The current study also makes a deeper analysis of the way lateral malleolar fractures, AO/OTA 44B1, were examined, classified and treated over the same time period at one of Swedens largest orthopedic centers. Do not walk on a sprained ankle. The current study describes the epidemiology of ankle fractures based on 1328 consecutive patients registered prospectively in the SFR during a 2-year period. You may require the use of a walker boot after surgery, and rehabilitation with a Physical Therapist can last for 6-12 weeks. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. If the bone fails to unite, surgery may be required, and for different types of fractures, different forms of stabilisation are required ranging from a screw fixation to an ORIF. The AO/OTA-classification of ankle fractures compared with the Lauge-Hansen classification of SER-injuries (supination-external rotation). Injury. This is not medical advice. }P[i n$:~[e=NG2M'iD%vG$?Gwr1:>*$0+eR3He[' <7Mx[wAU 2008;90(6):4837. One limitation in the current study is, however, the lack of a long-term follow up, most importantly for the non-surgically treated B1 fractures with medial tenderness with respect to displacement and a subsequent need for surgery. 2011;32(2):1417. They are usually caused by landing on a twisted foot, or from direct impact or trauma. 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