4 The Operative Treatment of Fracture-Dislocation of the Ankle Joint

1965 ◽  
Vol &NA; (42) ◽  
pp. 37???50
Author(s):  
PRESTON A. WADE ◽  
EUGENE M. LANCE
Author(s):  
Prasanna Anaberu ◽  
R. Prathik ◽  
R. Manish

<p class="abstract">Anterior ankle dislocation with associated compound bi-malleolar fracture is a rare injury. Ankle fracture dislocations most frequently occurs in young males caused by high energy trauma. The direction of the joint dislocation is determined by the position of the foot and the direction of the force being applied. A middle aged male presented to us with history of road traffic accident and was diagnosed to have anterior dislocation of right ankle joint with compound bi-malleolar fracture. Patient was taken to emergency operation theatre for wound debridement and immediate ankle reduction done under sedation. Due to wound contamination fracture fixation was delayed, once the wound healed bi-malleolar fracture fixation was done.</p>


2004 ◽  
Vol 53 (2) ◽  
pp. 332-337 ◽  
Author(s):  
Keisuke Mori ◽  
Kazunari Nishitsuji ◽  
Hiroyuki Araki ◽  
Tatsuya Imai ◽  
Hiroshi Inoue

2021 ◽  
Vol 3 (1) ◽  
pp. e000098
Author(s):  
Tero Kortekangas ◽  
Ristomatti Lehtola ◽  
Hannu-Ville Leskelä ◽  
Simo Taimela ◽  
Pasi Ohtonen ◽  
...  

Roughly two-thirds of ankle fractures are unimalleolar injuries, the Weber B-type fibula fracture being by far the most common type. Depending on the trauma and the accompanying soft-tissue injury, these fractures are either stable or unstable. Current clinical practice guidelines recommend surgical treatment for unstable Weber B-type fibula fractures. An ongoing randomized, parallel group, non-inferiority trial comparing surgery and non-operative treatment for unstable Weber B-type ankle fractures with allocation ratio 1:1. The rationale for non-inferiority design is as follows: By being able to prove non-inferiority of non-operative treatment, we would be able to avoid complications related to surgery. However, the primary concern related to non-operative treatment is increased risks of ankle mortise incongruency, leading to secondary surgery, early post-traumatic osteoarthritis and poor function. After providing informed consent, 126 patients aged 16 years or older with an unimalleolar Weber B-type unstable fibula fracture were randomly assigned to surgery (open reduction and internal fixation) or non-operative treatment (6-week cast immobilization). We have completed the patient enrolment and are currently in the final stages of the 2-year follow-up. The primary, non-inferiority outcome is the Olerud-Molander Ankle Score (OMAS) at 2 years (primary time point). The predefined non-inferiority margin is set at 8 OMAS points. Secondary outcomes include the Foot and Ankle Score, a 100 mm Visual Analogue Scale for function and pain, the RAND-36-Item Health Survey for health-related quality-of-life, the range-of-motion of the injured ankle, malunion (ankle joint incongruity) and fracture union. Treatment-related complications and harms; symptomatic non-unions, loss of congruity of the ankle joint, reoperations and wound infections will also be recorded. We hypothesize that non-operative treatment yields non-inferior functional outcome to surgery, the current standard treatment, with no increased risk of harms.


1995 ◽  
Vol 44 (4) ◽  
pp. 1446-1448
Author(s):  
Noboru Yamaguchi ◽  
Masafumi Inoue ◽  
Tatsuya Ogata

2018 ◽  
Vol 5 (7) ◽  
pp. 2660
Author(s):  
Lokesh Kumar S. N. ◽  
Deepak Kumar ◽  
Sameer Aggarwal

Simultaneous dislocation of three joints the hip knee and ankle joint in an ipsilateral limb is a very rare pattern of injury and only a single case has been reported in the literature, but it is associated with acetabulum fracture. A 34-year-old male had met with a road traffic accident involving left lower limb. Radiographic examination revealed (i) Posterior dislocation of the hip joint without any fracture (ii) Posterior dislocation of the knee joint(iii)Open fracture dislocation of the ankle joint with medial malleolus fracture tibial pilon fracture. The patient underwent an immediate closed reduction of the hip joint by Allis method. Simultaneous reduction of the knee and ankle joint was done and appropriate splintage gave. Open wounds were well debrided and trans-articular fixator was placed over knee and ankle joint. At a second stage, the medial malleolus fracture and tibia pilon fracture were fixed. MRI scan was done which revealed an anterior cruciate ligament injury of the knee. At 6-month follow-up, the patient was ambulating with full weight-bearing on both lower extremities without any assistive devices. There always lies a high risk of hemodynamic instability and other serious and life-threatening injuries due to the high velocity of trauma involved in such cases. The outcome of ipsilateral hip knee and ankle dislocation can vary widely depending on the circumstances and other associated injuries.


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