5-Minute Emergency Consult
Ankle Fracture/dislocation
Basics
Description
Common mechanisms and injury patterns of the ankle:Description
- 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
- Posterior dislocation is most common. Results from backward force on plantar flexed foot. Often with rupture of tibiofibular ligaments or lateral malleolus fracture
- Inversion injury: Lateral ankle distraction and medial ankle compression
- 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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Citation
Schaider, Jeffrey J., et al., editors. "Ankle Fracture/dislocation." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307726/all/Ankle_Fracture_dislocation.
Ankle Fracture/dislocation. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307726/all/Ankle_Fracture_dislocation. Accessed December 21, 2024.
Ankle Fracture/dislocation. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307726/all/Ankle_Fracture_dislocation
Ankle Fracture/dislocation [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 21]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307726/all/Ankle_Fracture_dislocation.
* Article titles in AMA citation format should be in sentence-case
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T1 - Ankle Fracture/dislocation
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ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307726/all/Ankle_Fracture_dislocation
PB - Lippincott Williams & Wilkins
ET - 6
DB - Emergency Central
DP - Unbound Medicine
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