Dr. Ebraheim’s educational animated video describes fractures of the ankle, classifications and ankle X - rays.
It describes ankle fracture classification, ankle fracture dislocation.
It also describes ankle fracture treatment and ankle fracture surgery and ankle fracture recovery and ankle fracture cast and brace.
There is a lot of important topics in ankle fractures.
Classifications of ankle fractures:
• Weber classification: it classifies the ankle fracture according to the level of the fibular fracture:
- Type A: the fracture is below the syndesmosis, this fracture is rarely unstable, but it could have syndesmotic injury.
- Type B: its common, the fracture occurs at the level of the syndesmosis, the fracture could be unstable.
- Type C: the fracture is above the syndesmosis, and is usually unstable, if you have a fracture weber c and you have a deltoid injury, you most likely need a syndesmotic screws, because the syndesmosis will be unstable.
• Lauge Hansen classification: depends on the mechanism of the injury: depend on 2 things: position of the foot, and the force applied:
1- Supination- Adduction: there is a vertical fracture of the medial malleolus, movement of the talus medially, possible anteromedial tibial plafond impaction, transverse fracture of the distal fibula.
How you fix it: screws parallel to the joint or anti-glide plate.
With the injury having also the plafond impaction: you probably need to open the joint and elevate and restore the joint surface, and also this is the one that you may want to start medially, not laterally as we do routinely for other ankle fractures.
2- Supination- External rotation injury: the most common injury.
Look at the lateral x-ray look at the fibula too, look on the AP and the lateral view radiograph.
So if you find the fracture start from anterior inferior going posterior superior, that is supination external rotation injury, this is the one that can give you trouble if the fibula appear as the only bone that is fractured, you want to make sure that you are not missing type 4 fracture type.
This injury has 4 stages, 4 will be on the medial side.
3- Pronation- External rotation: in this case the fracture goes from anterior superiorly to posterior inferior, and the fracture usually above the joint interval, it usually is weber C.
4- Pronation- Abduction injury: fracture of the fibula is usually transverse or comminuted; the fractured ankle may have only to the syndesmosis with nothing else appearing on x-ray.
This fracture will start medially and will cause deltoid ligament injury, and then it probably moves to the syndesmosis at the following stage and ends by fibula, so it may come a little earlier so you don’t see a fibular fracture because it never happened, but you have syndesmotic injury.
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25 авг 2016
