- Trimalleolar fx skin#
- Trimalleolar fx full#
Twisting with the foot planted on the ground and the body rotating around it is the most common mechanism of injury. Ankle fractures range from simple injuries of a single bone to complex ones involving multiple bones and ligaments. Occasionally, they involve the shaft of the fibula as well. (Simanski CJ, JOT 2006 20:108).Ankle fractures are breaks of the distal tibia or fibula (near or in the so-called malleolus) affecting the tibiotalar (ankle) joint. 100% good results Olerud score (90 +/- 13 points).
Trimalleolar fx full#
Average time to full weightbearing = 7weeks, return to work = 8weeks after surgery with early weight bearing protocol. Smoking history, presence of a medial malleolar fracture, lower levels of education are significant independent predictors of lower physical function up to 3 months postoperation. Physical function and role physical scores remain significantly lower than US norms at 24 months after operative fixation. 6 Months: Return to sport / full activities. Running, stair-climbing, and participation in sports are allowed only after a full range of motion of the ankle has been achieved Rx=compression stocking (sigvaris, Jobst) 20-30mmHg Swelling is common after ankle sprain or fx. Driving: may drive after 9 weeks for right leg. Encourage daily active and passive range-of-motion exercises of the ankle and subtalar joints without the brace. 7-10 Days: Wound check, functional Air-Stirrup ankle brace (Aircast). Post-op: bulky jones dressing, NWB, elevation. We discussed the risks of surgery including, but not limited to: incomplete relief of pain, incomplete return of function, nonunion, malnunion, painful hardware, hardware failure, compartment syndrome, CRPS, DVT/PE and the risks of anesthesia including heart attack, stroke and death. Peroneal tendon pathology: associated with low plate placement with a prominent screw head in the distal hole. Lateral malleolar fixation provided with posterior antiglide plate +/- lag screws. document osteochondral injuries which should be saught during ORIF. Prep and drape in standard sterile fashion. Well-padded tourniquet placed high on the thigh. Supine position with bump under ipsilateral hip. Pre-operative antibiotics, +/- regional block. FHL is medial and protects posterior tibial artery/nerve. Find interval between FHL and peroneal tendons. Incision between Achilles and peroneal tendons. Posterior approach only needed for large posterior malleolar fragments-prone position. Posterior malleolar fragments >25% of the plafond may be fixed via percutaneous clamp reduction through the medical mallellar fracture or direct reduction through a posterolateral or posteromedial approach. Trimalleolar fx skin#
Delayed surgery done when blisters have resolved, skin wrinkles normally (average 14 days) has equivalent outcomes (Karges/Watson, JOT 1995 9:377). Ideally surgery is done before any true swelling or fracture blisters have developed. Timing of surgery is dictated by the status of the soft tissues.ORIF Ankle Fracture Pre-op Planning / Special Considerations Soft tissue compromise - severe swelling.Lateral malleolus fracture with syndesmosis injury.Lateral malleolus fracture with tibio-talar instability.Synonyms: ORIF Ankle Fracture, open reduction internal fixation ankle, medial malleolus ORIF, lateral malleolus ORIF
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