Ankle Injuries

Ankle Injuries

Dr. Wahby Ghalib CABMS, FJMC, MRCS

Tibiofibular syndesmosis

Anterior TFL Posterior TFL Interosseous membrane Inferior transverse ligament

Lateral collateral ligament

Anterior talofibular ligament Posterior talofibular ligament Calcaneofibular ligament

Deltoid ligament

Major ankle stabilizer Superficial part Deep part

LCL injury

90 % of ankle ligament injury Usually sprain of anterior talofibular ligament Mechanism : inversion

Associating injuries

Fibular # MTB # Peroneal tendon sheath injury Syndesmotic injury


Rx
Partial injury : crepe bandage

Complete injury : athlete : repair otherwise : cast 6w

Ankle fractures

Classification (Danis & Weber)

A :

Fibular # below syndesmosis Results from supination + IR Syndesmosis is intact


B :
Fibular # at level of syndesmosis Results from supination + ER Partial injury of syndesmosis Commonest ankle injury

C :

Fibular # above the syndesmosis Results from pronation + ER Syndesmosis is disrupted


XR


Rx
Swelling is rapid & severe So surgery has to be early

Undisplaced #

A % B : back slab 2-3 m C : deceivingly innocent : ORIF

Displaced #

A & B : CR + K. Wire If irreducible : ORIF C : ORIF

Cx
Wound break-down & infection RSD Joint stiffness OA


Pilon Fracture

It is fracture of tibial plafond = distal tibial intraarticular #

Mechanism
FFH  talus hits the lower tibia

Rx
Swelling is severe : if surgery done  wound break-down & infectionCalcaneal traction & elevationORIF

Objectives :

Stressing the importance of ankle injuries as being the most common lower limb injuries with significant morbidity. Training the students to acquire the basic skills of management including diagnosis reduction and POP stabilization.

Objectives :

Stressing the close follow up of ankle injuries as being liable for significant soft tissue complications. Clarifying the importance of proper classification of ankle fractures as being the key for proper management.

Objectives :

Stressing the importance of physiotherapy in ankle fractures.