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70 Cards in this Set
- Front
- Back
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what is the load bearing part of the ankle joint
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tibial plafond
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what ligament prevents anterior displacement of talus
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ATFL
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what ligaments prevents excessive talar tilt
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CFL
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what is the most important medial structure
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deep deltoid ligament
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what is the most improtant stabilizgin soft tissues of the ankle
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syndesmosis
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what are the parts of the syndesmosis
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anterior inferior tibiofibular ligament
posterior inferior tibiofibular ligament interosseous membrane |
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AITFL pulls off of tibia
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tillaux fracture
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AITFL pulls off of fibula
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wagstaff
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ankle fracture classifications
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lauge-hansen
danis-weber |
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the first word in lauge hansen describes what
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position of the foot at time of injury
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the second word in lauge-hansen describes what
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mechanism of injury
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what are the classifications in lauge-hansen classification
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supination adduction
pronation abduction supination external rotation pronation external rotation |
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how many stages are there with supination adduction injuries
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2
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what is stage 1 in supination adduction
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transverse fibular fracture at or below the joint rupture of lateral collateral ligaments
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what is stage 2 in supination adduction
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superiorly oriented medial malleolar fracture
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stage 1 in pronation abduction injury
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rupture of deltoid or medial malleolar fracture
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stage 2 in pronation abduction injury
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rupture of anterior and posterior inferior tibiofibular ligaments or respective avulsion fractures
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stage 3 in pronation abduction
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oblique fracture of the fibular at joint line
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pronation abduction injuries on lateral radiograph are what type of injuries
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transverse plane injuries
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oblique injuries on lateral radiograph suggest what classification
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external rotation
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supination external rotation stage 1
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rupture of anterior inferior tibiofibular or respective avulsion fracture
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SER stage 2
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spiral fracture at joint line
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SER stage 3
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rupture of posterior inferior tibiofibular ligament or posterior malleolar fracture
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SER stage 4
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rupture of the deltoid ligament or medial malleolar fracture
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what is most common ankle fracture
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SER 2
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PER 1
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rupture of the deltoid ligament or medial malleolar fracture
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PER 2
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rupture of anterior inferior ligament or respective avulsion fracture
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PER 3
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spiral fracture of fibula above joint
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PER 4
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rupture of posteior inferior tibiofibular ligament or posterior malleolar fracture
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which ankle fracture has worst prognosis
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PER
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what do you worry about with high fibular fractures
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common peroneal nerve
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what can you assume with high fibular fractures
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syndesmosis distal to fracture has been compromised
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type A dannis weber
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fibular fracture below the joint line stable syndesmosis usually transverse
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Type A dannis weber correlation to lauge-hansen
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SA
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type B dannis weber
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fibular fracture at the joint line spiral or oblique partial syndesmosis instability
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type B dannis weber correlation to lauge hansen
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SER
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type C dannis weber
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fibular fracture above the joint line complete syndesmosis instability
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type C dannis weber correlation to lauge hansen
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PER
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mechanism for pilon fractures
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high velocity injury involving distal tibial metaphysis with extension into the joint
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what is the neccessary distance for skin bridge when fixing pilon fractures
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7cm
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how do bones ossify
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start centrally continue medially and end laterally
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what are pediatric transitional fractures
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fractures called transition due to occurence close to time of skeletal maturity
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Juvenille tillaux fracture
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fracture of the lateral aspect of the distal tibial physis
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juvenille tillaux fractures appear as what on AP radiograph
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salter harris type 3
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what must be ruled out with juvenille tillaux fractures
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diastasis injury
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what force usually causes triplane fracture
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external rotation force
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what do triplane fractures appear as on AP
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salter harris 3
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what do triplane fractures appear as on lateral
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salter harris 2
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what areas should be palapated for suspected traume with ankle fracture
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malleoli, proximal fibula, achilles, lisfrancs complex, 5th met base, anterior calcaneal process
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when should CT be ordered
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intra articular involvement
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distance between medial fibula and posteior lateral tibial
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tibiofibular clear space
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what happens to tibiofibular clear space with diastasis injury
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increases
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distance between anterior lateral tibia and medial fibula
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tibiofibular overlap
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what happens to tibiofibular overlap with diastasis injury
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decreases
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what ruptures before syndesmosis ruptures
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deltoid ligament
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three principles in closed reduction
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exaggerate deformity
distract joint reverse deformity |
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what types of medications are given to close reduce
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narcotics and benzos together
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what kinds of splints are added after closed reduction
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posterior and sugar tong splints
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what are two types of fracture blisters
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hemorrhagic and serous
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do not do what in the presence of fracture blisters
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cut the patient
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AO-ASIF tenets
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restoration of anatomy
establish stability preservation of blood supply early mobilization of limb and patient |
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indication for surgery on ankle fractures
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2-3mm displacement of either malleolus or plafond or >10 degrees of angulation in one cardinal plane
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this happens with all ankle fracture cases
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prophylaxis
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where is lateral incision placed
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midline of fibula
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when do you place you incision more posterior on fibula
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when applying antiglide plate or a pilon fracture
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what type of incision is placed medially
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curvilinear
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the keys to successful ORIF
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restoration of fibular length and postion and stabilization of medial soft tissue
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rule of 3s with syndesmotic repair
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3cm above joint line
angle screws 30 degrees posteior lateral to anterior medial 3.5mm screws |
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ways to evaluate sydesmotic fixation
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hook test
external roation test |
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when should volkmans fracture be fixated
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when posteior malleolar fracture is >25-30% of the tibial plafond
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