Injuries of the Ankle and Foot
Louis Solomon, David Warwick, Selvadurai Nayagam in Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
About 15% of ankle sprains reaching the Emergency Department are associated with an ankle fracture. X-ray examination is called for if there is: Pain around the malleolus.Inability to take weight on the ankle immediately after the injury.Inability to take four steps in the Emergency Department.Bone tenderness at the posterior edge or tip of either of the malleoli or the base of the fifth metatarsal bone.
Injuries of the ankle and foot
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
About 15% of ankle sprains reaching the Emergency Department are associated with an ankle fracture. This complication can be excluded by obtaining an X-ray, but there are doubts as to whether all patients with ankle injuries should be subjected to X-ray examination. More than 20 years ago The Ottawa Ankle Rules were developed to assist in making this decision. X-ray examination is called for if there is: (1) pain around the malleolus; (2) inability to take weight on the ankle immediately after the injury; (3) inability to take four steps in the Emergency Department; (4) bone tenderness at the posterior edge or tip of the medial or lateral malleolus or the base of the fifth metatarsal bone.
Ankle injuries
Sebastian Dawson-Bowling, Pramod Achan, Timothy Briggs, Manoj Ramachandran, Stephen Key, Daud Chou in Orthopaedic Trauma, 2014
Initial management of all ankle fracture-dislocations requires reduction and immobilization, usually in a below knee back-slab. If left unreduced, there is a risk of vascular compromise, pressure ischaemia, articular damage and prolonged soft tissue swelling of the ankle. In many emergency departments it is now possible for patients to undergo preliminary imaging at triage; if so, obtaining images before initial reduction may help operative planning. However, if there is gross dislocation clinically, initial reduction should never be delayed to obtain radiographs because skin necrosis can progress rapidly.
Traumatic jejunal perforation associated with SARS-CoV-2 (COVID-19) infection
Published in Baylor University Medical Center Proceedings, 2021
Jonathan Kopel, Luong Linda, Irfan Warraich, Grant Sorensen, Gregory L. Brower
The patient had two large lacerations in the right periorbital region. An obvious open right ankle fracture with the talus extruded from the ankle wound and deformity to the right thumb were noted. Computed tomography (CT) of the head showed a large subgaleal hematoma with areas of active bleeding in the right frontoparietal region measuring up to 9 cm in the transverse and 2 cm in the vertical dimensions, without underlying calvarial fracture. No acute intracranial abnormality or fracture in the cervical spine was noted. CT of the body with contrast showed a small amount of free fluid in the right paracolic gutter and the cul-de-sac. There was a nondisplaced fracture of the left first rib. The patient had an elevated white blood cell count (14,760/mm3), with neutrophilia (12,720/mm3) and lymphopenia (1,170/mm3). She was also found to be positive for COVID-19 using the Abbott ID NOW COVID-19 rapid nucleic acid amplification test from nasal swab samples collected before surgery. The patient did not report any symptoms related to COVID-19 or recall any known exposures or contacts.
Plausible mechanisms of and techniques to assess ankle joint degeneration following lateral ankle sprains: a narrative review
Published in The Physician and Sportsmedicine, 2019
Kyeongtak Song, Erik A. Wikstrom
Previous data has observed that 89% of young patients (mean age of 19 years) with a severe acute ankle sprain had talar chondral lesions [19]. The talar chondral lesions are commonly found arthroscopically on the medial aspect of the talus in patients with acute LAS and CAI [17,19]. During a typical LAS, it is speculated that the medial talar dome impacts the inner surface of the medial malleolus or tibial plafond, which may result in a talar osteochondral lesion on the medial talus. Empirical data also indicates that a partial or complete tear of the anterior talofibular ligament (ATFL) results in early degenerative changes in the anteromedial and anterolateral regions of the talar dome compared to an uninjured ankle [21]. Similarly, research shows that articular cartilage damage at the time of an ankle fracture also increases the risk of PTOA [22]. Cumulatively, the evidence suggests that osteochondral lesions during a traumatic ankle injury is sufficient to cause degenerative changes.
Reduced incidence and economic cost of hardware removal after ankle fracture surgery: a 20-year nationwide registry study
Published in Acta Orthopaedica, 2020
Nikke Partio, Tuomas T Huttunen, Heikki M Mäenpää, Ville M Mattila
68,865 adult patients (51% women) had an ankle fracture surgically treated with ORIF in Finland during the 20-year study period between 1997 and 2016. The mean age at the time of the 1st surgery in 1997 was 52 years in women and 44 years in men. In 2016, the corresponding ages were 57 years in women and 47 years in men. The total incidence of ankle fracture surgery was 81 (CI 78–83) per 100,000 person-years in 1997 (3,218 operations) and 74 (CI 71–76) per 100,000 person-years in 2016 (3,276 operations) (Figure 1). In men, the incidence was 87 (CI 83–91) per 100,000 person-years in 1997 and 72 (CI 68–75) per 100,000 person-years in 2016. In women, the corresponding figures were 80 (CI 76–84) per 100,000 person-years in 1997 and 82 (CI 79–86) per 100,000 person-years in 2016.
Related Knowledge Centers
- Ankle
- Compartment Syndrome
- Malleolus
- Blunt Trauma
- Bruise
- High Ankle Sprain
- Malunion
- Post-Traumatic Arthritis
- Bimalleolar Fracture
- Trimalleolar Fracture