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  • The following term was not found in PubMed: 2015;54.
J Foot Ankle Surg. 2015 Nov-Dec;54(6):1042-6. doi: 10.1053/j.jfas.2015.04.025. Epub 2015 Jul 16.

Weightbearing Radiographs Facilitate Functional Treatment of Ankle Fractures of Uncertain Stability.

Author information

1
Speciality Registrar, Department of Trauma and Orthopaedic Surgery, Royal Blackburn Hospital, Blackburn, Lancashire, United Kingdom. Electronic address: grhastie@doctors.org.uk.
2
Speciality Registrar, Department of Trauma and Orthopaedic Surgery, Royal Blackburn Hospital, Blackburn, Lancashire, United Kingdom.
3
Consultant, Department of Trauma and Orthopaedic Surgery, Royal Blackburn Hospital, Blackburn, Lancashire, United Kingdom.

Abstract

The most important determinant in the treatment of malleolar fractures is stability. Stable fractures have an intact deep deltoid ligament and do not displace with functional treatment. If the deep deltoid/medial malleolar complex is disrupted, the talus is at risk of displacement. Weber (2010) showed that weightbearing radiographs predicted stability in patients with undisplaced ankle fractures. We developed clinical criteria for potential instability and applied them to a prospective series of patients. The criteria included a medial clear space of <4 mm; medial tenderness, bruising or swelling; a fibular fracture above the syndesmosis; a bimalleolar or trimalleolar fracture; an open fracture; and a high-energy fracture mechanism. A prospectively documented series of 43 patients chose functional brace treatment of the potentially unstable fractures. Weightbearing radiographs were performed with the patient wearing the brace before treatment and free of the brace at clinical union (6 to 9 weeks for all patients). The patients were encouraged to bear full weight and actively exercise their ankles in the brace. All fractures healed without displacement. The risk of displacement was 0% (95% confidence interval 0% to 9.5%). The results of the present preliminary series give support for the use of weightbearing radiographs to guide treatment of undisplaced ankle fractures.

KEYWORDS:

fibula; ligament; malleolus; stability; talus; tibia; weightbearing

PMID:
26190779
DOI:
10.1053/j.jfas.2015.04.025
[Indexed for MEDLINE]

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