Ankle Fractures: A Literature Review of Current Treatment Methods

Abstract

Ankle fracture is one of the most common lower limb fractures for they account for 9% of all fractures representing a significant portion of the trauma workload. Ankle fractures usually affect young men and older women, however, below the age of 50; ankle fractures are the commonest in men. Two commonly used classification systems for ankle fractures include the danis weber AO classification and the Lauge-Hansen classification. There is biomechanical evidence that posterior non-locking plates are superior in stability than laterally placed plates; however there is little clinical evidence. There are several different methods of ankle fracture fixation, however the goal of treatment remains a stable anatomic reduction of talus in the ankle mortise and correction of the fibula length as a 1 mm lateral shift of the talus in the ankle mortise reduces the contact area by 42%, and displacement (or shortening) of the fibula more than 2 mm will lead to significant increases in joint contact pressures. Further research both biomechanically and clinically needs to be undertaken in order to clarify a preferable choice of fixation.

Caso Clínico: Fractura de Tobillo Weber B, Tratamiento Quirúrgico con Doble Sistema Tightrope®

“…El tratamiento quirúrgico incluye la reducción de las partes fracturadas y la fijación mediante dispositivos como placas de metal, tornillos, bandas de tensión, fijación externa, entre otros [1]. Los objetivos del tratamiento deben incluir la restauración anatómica, estabilización de la articulación, disminuir el dolor, la preservación de la sensibilidad, la longitud del miembro inferior, rápida movilización, prevenir artrosis y minimizar la incapacidad laboral [1,3,4,7].…”

“…Las fracturas de tobillo son una causa frecuente de visita a los servicios de Emergencia y representan el 25 % del total de las fracturas de miembro inferior; en Reino Unido constituyen el 9 % de todas las fracturas atendidas en los servicios de salud y en Estados Unidos representan una incidencia anual de 184 personas por cada 100000 habitantes [1]. Dentro de la población atlética, la incidencia se incrementa entre 12 y 32 %, sobre todo en deportes que involucran fuerzas externas sobre el tobillo [2].…”

Treatment of B3 type fractures of shin bones associated with Volkmanns triangle fracture

“…Á³ëüø³ñòü ïåðåëîì³â ñóïðîâîäaeóþòüñÿ ïîøêîäaeåííÿì çâ'ÿçêîâîãî àïàðàòó. Òèï ïåðåëîìó âèçíà÷àºòüñÿ âåëè÷èíîþ òà íàïðÿìêîì 䳿 ñèëè íà ãîì³ëêîâî-ñòóïíåâèé ñóãëîá [6]. ²ñíóº äåê³ëüêà ìåòîä³â ô³êñàö³¿ ê³ñ-òî÷îê, õî÷à, ö³ëëþ ë³êóâàííÿ çàëèøàºòüñÿ ñòà-á³ëüíà àíàòîì³÷íà ðåïîçèö³ÿ òà ïîçèö³îíóâàííÿ ëàòåðàëüíî¿ ê³ñòî÷êè â ãí³çä³ òàðàííî¿ ê³ñòêè (ìàëîãîì³ëêîâà âèð³çêà) ãîì³ëêîâî-ñòóïíåâîãî ñóãëîáà ³ êîðåêö³ÿ äîâaeèíè ìàëîãîì³ëêîâî¿ ê³ñòêè, îñê³ëüêè ëàòåðàëüíèé çñóâ òàðàííî¿ ê³ñòêè íà 1 ìì.…”

Lateral Malleolus Hook-Plate Fixation in the Treatment of Herscovici Type B Medial Malleolar Fractures: The Clinical Evaluation of an Alternative Fixation Technique

“…The medial malleolus is crucial importance for keeping the stability of ankle. Whether isolated or a more complex pattern of medial malleolus fractures, optimal fixation methods should be concerned [1]. The aim of operative treatment in ankle fractures is to provide stable internal fixation and allow early motion.…”