$lateral malleolus fracture bruising$ $lateral malleolus fracture bruising$

#Lateral malleolus fracture bruising skin

Type 1: coronal fracture with no dislocation. Sangeorzan Classification of Navicular Body Fractures The navicular bone is particularly at risk for avascular necrosis, difficult to diagnose, and therefore a high index of suspicion is required to identify this injury.

$lateral malleolus fracture bruising$

Significantly displaced fractures often require orthopaedic intervention. The majority consist of minor avulsion or stress fractures. Most isolated midfoot fractures affect the navicular or more rarely the cuboid bones. Koval, K & Zuckerman, J (2002) Handbook of fractures, Philadelphia: Lippincott Williams and Wilkins.Pain from the fracture and restriction of movement is usual for 2-3 weeks and will require regular, then prn analgesia Malunion may occur with a lateral malleolus fracture that is shortened or rotated, a displaced posterior or medial malleolus fracture or a talar shift.Īrthritic changes can occur due to damage at time of injury or malunion. Orthopaedic review in ED or within 1-2 days NWB.Ĭlean and dress wound, short leg backslab. CT is the best way to determine articular displacement.Ī Short leg backlsab should be applied, NWB mobility, for all posterior malleolus fractures. NWBĪs with medial malleolar fractures care should be taken to rule out any other injury about the ankle which would indicate instability.įractures that involve >25% of the articular surface or a displaced >2mm usually require an ORIF. These fractures are unstable and require ORIF. If medial malleolar injury is truly isolated then a short leg backslab should be applied and the patient is to remain NWB until orthopaedic review. Any other fracture, ligament injury or talar shift indicate the fracture is likely to be unstable and should be reviewed by orthopaedics. The entire length of the fibula should be palpated and x-rayed to rule out any Maisonneurve type injuries. With medial malleolus fractures care should be taken to rule out any other fracture or injury around the ankle. A short leg backslab, ankle at plantargrade, should be applied. These fractures should be placed in a short leg backslab and remain NWB.įibular fractures which are displaced >3mm, have associated medial malleolar fracture or medial ligament injury are unstable and require orthopaedic review. Isolated fibular fractures at the level of the syndesmosis (Weber B) without associated medial injury should be placed in a short leg backslab (ankle at plantargrade) and remain NWB.įractures above the syndesmosis (Weber C) involve disruption of the syndesmosis and are usually associated with medial ankle injury. Talar shift or widening of the mortice indicates instability.įractures below the syndesmosis (Weber A avulsion type injuries) without associated medial ankle #/tenderness can be treated in a walking/CAM boot and may mobilise WBAT. Fractures distal to the syndesmosis are unlikely to be associated with ligamentous injury and therefore likely to be stable.įibula fractures that are associated with medial fractures or medial ligamentous injury are likely to be unstable despite normal alignment on x-ray. The stability of a fibula fracture determines treatment. Open wounds should be cleaned and dressed in a sterile manner.Fracture dislocations should be reduced.Site of tenderness (palpate entire length of fibula).

#Lateral malleolus fracture bruising skin

The skin should be assessed for any open injuries and the amount of soft tissues swelling.ĭislocations should be reduced and casted immediately. Neurovascular status should be carefully examined. From weight bearing with an antalgic gait to non-weight bearing with significant pain, swelling, discomfort and varying deformity. This type of injury includes Maisonneuve injuries.īased on foot position at time of injury and the force applied through the foot. Causes disruption of the syndesmosis and is usually associated with medial ankle injuries. Weber C - a fracture above the level of the syndesmosis.

$lateral malleolus fracture bruising$

May be associated with medial ankle injury/fracture or posterior malleolus fractures. Mechanism is external rotation of the foot. Weber B - a fracture at or near the level of the syndesmosis. Weber A - a fibular fracture below the level of the syndesmosis. Higher risk of syndesmotic disruption and instability is associated with more proximal fractures. Orthopaedic review either in ED or within 1-3 days.īased on the position of the fibular fracture. Reduction if required, short leg backslab, NWBĭisplaced/>25% of articular surface: short leg backslab, NWB Talar shift or medial malleolar fracture: reduction, short leg backslab Orthopaedic follow-up in ED or within 1-2 daysįibula fracture above syndesmosis (Weber C)Īnkle in normal anatomical position: short leg backslab NWB Weber B, displaced: short leg backslab, NWB Weber B, undisplaced: short leg backslab NWB

$lateral malleolus fracture bruising$