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Klinik und Poliklinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum "Carl Gustav Carus" der TU Dresden, Fetscherstrasse 74, 01307, Dresden. strammelt@hotmail.com
Ankle fractures belong to the most frequent injuries to the human skeleton. Correct treatment requires knowledge of the trauma mechanism and thorough analysis of the injured bony and ligamentous components. Isolated, non-displaced fractures of the medial or lateral malleolus are subject to non-operative, functional treatment with favorable long-term results provided that instability of the ankle mortise has been definitely ruled out. Fracture-dislocations have to be reduced as an emergency under sufficient analgesia to avoid severe soft-tissue complications. The most important prognostic factors after operative treatment are exact reconstruction of the articular surfaces and correct position of the distal fibula within the tibial incision after a mechanically relevant syndesmosis rupture. Besides malalignment, negative prognostic factors include delayed reduction, injury of several ankle components and hereditary or acquired neuropathy.
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