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Ankle Fracture/dislocation

Ankle Fracture/dislocation is a topic covered in the 5-Minute Emergency Consult.

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Common mechanisms and injury patterns of the ankle:
  • Mechanism of injury:
    • Inversion injury: Lateral ankle distraction and medial ankle compression
      • Avulsion fracture of the lateral malleolus
      • Oblique fracture of the medial malleolus
    • Eversion injury: Medial ankle distraction and lateral ankle compression
      • Avulsion fracture of medial malleolus
      • Oblique fracture of the fibula
    • External rotation injury:
      • Disruption of the tibiofibular syndesmosis, or a fibular fracture above the plafond
      • Anterior or posterior tibial fracture with separation of the distal tibia and fibula (unstable fracture)
    • Inversion and external rotation (Maisonneuve fracture):
      • Medial malleolus avulsion fracture or deltoid ligament tear
      • Disruption of the tibiofibular syndesmosis
      • Oblique fracture of the proximal fibula
    • Inversion and dorsiflexion (snowboarders’ fracture):
      • Fracture of the lateral process of the talus
  • Epidemiology
    • Most ankle fractures are malleolar
    • Common in young male and 50–70 yr old female
    • Associated with cigarette use and high BMI

Pediatric Considerations
  • Ankle fractures in children often involve the physis (growth plate):
    • May result in angular deformity from growth plate injury
    • Associated with sports requiring sudden changes in direction and obese children
    • In children <10 yr old, growth plate is weaker than epiphysis
  • Tillaux fracture: Salter–Harris type III injury of the anterolateral tibial epiphysis external rotation of the foot
  • Triplane fracture: Uncommon fracture of distal tibia with fracture lines in 3 distinct planes (coronal, transverse, sagittal)

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Rosen, Peter, et al., editors. "Ankle Fracture/dislocation." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307690/all/Ankle_Fracture_dislocation.
Ankle Fracture/dislocation. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307690/all/Ankle_Fracture_dislocation. Accessed April 23, 2019.
Ankle Fracture/dislocation. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307690/all/Ankle_Fracture_dislocation
Ankle Fracture/dislocation [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307690/all/Ankle_Fracture_dislocation.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Ankle Fracture/dislocation ID - 307690 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307690/all/Ankle_Fracture_dislocation PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -