Ankle fractures

March 2018 | by EMauthor


Unimalleolar fractures


Undisplaced, below knee back slab. Crutches and fracture clinic follow up

Displaced or with talar shift, refer to orthopaedics

Remember the Maisonneuve fracture, it requires surgery, refer


Bimalleolar and Trimalleolar fractures


Correct any gross deformity before or after x-ray

Temporary back slab splint

Refer to orthopaedics


Fracture/Dislocation of ankle  


There is serious risk of necrosis of stretched skin

Reduce dislocation urgently (usually) before sending to x-ray with iv analgesia/sedation, the aim is primarily to relieve the pressure on the skin

Check pedal pulses before and after reduction

Apply temporary back slab splint and then x-ray

Refer to orthopaedics urgently


 Key point:  alignment does not have to be perfect: it is to reduce the risk of necrosis of stretched skin. Re-sedating a patient is a considerable risk and should be avoided.


Avulsion fractures of malleoli


Analgesia

Walking stick or crutches

Fracture clinic follow up and consider (psychological) Tubigrip



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