6/12/2023 0 Comments Broken ankle xrayCompare joint spaces between the talus and medial malleolus, talus and lateral malleolus, and talus and tibial plafond.Evaluate for radiographic fracture signs, displacement, and dislocation.3-view plain ankle x-ray : anteroposterior (AP), lateral and mortise (oblique) views.Foot x-rays are indicated for pain in the midfoot region PLUS any of the following:.Weight-bearing is impossible both immediately post-injury and in the ED.Tenderness along the posterior distal 6 cm of the:.Ankle x-rays are indicated for pain in the malleolar region PLUS any of the following:.These criteria are used to determine the need for X-rays in patients presenting to the emergency department (ED) with traumatic ankle and/or foot injuries. Associated injuries: Examine the foot and knee.Įxamine the entire length of the fibula in patients with ankle pain to evaluate for a Maisonneuve fracture.Skin exam: Evaluate for laceration, tearing, and tenting.Examine motor and sensory function of the lower leg (see “ Sural nerve injury”, “ Tibial nerve injury”, and “ Peroneal nerve injury”).Assess dorsalis pedis and posterior tibial artery pulses and distal capillary refill time.Perform the following prior to imaging as abnormalities can affect urgent management (see “Approach” in “Treatment”): Maisonneuve fractures are considered Weber C fractures. Medial malleolus fracture and/or deltoid ligament tear.Ruptured syndesmosis, torn interosseous membrane. Weber C: fibular fracture above the syndesmosis.Possible syndesmotic injury and/or deltoid ligament injury.Weber B: fibular fracture at the level of the syndesmosis.Intact syndesmosis and deltoid ligament.Weber A: lateral malleolar fracture below the syndesmosis.The Weber classification categorizes ankle fractures according to the level of the fibular fracture in relation to the distal tibiofibular syndesmosis. Always unstable: trimalleolar fracture, pilon fracture.Usually unstable: posterior malleolar fracture, bimalleolar fracture, Maisonneuve fracture.Usually stable: isolated lateral malleolar fracture of isolated medial malleolar fracture.Generally, fractures at two or more sites are unstable. The ankle becomes increasingly unstable with worsening severity of injury. Other: Volkmann triangle refers to an avulsion fracture of the posterolateral tibial lip.
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