![]() Because the talus is asymmetrically shaped, movement in the ankle joint is not a pure hinge movement, but rather a rotatory hinging movement around the helical axis of the joint ( 3). Powerful collateral ligaments stabilize the joint against stress from the sides: laterally, the anterior fibulotalar ligament (AFTL), fibulocalcanear ligament (FCL), and posterior fibulotalar ligament (PFTL), and, medially, the broad fan of the deltoid ligament and the plantar calcaneonavicular ligament (spring ligament), whose medial border is blended with the forepart of the deltoid ligament. The tibia and fibula are elastically bound in the fork of the ankle joint by the ligamentous structures of the syndesmosis (interosseous membrane anterior, posterior, and transverse tibiofibular ligaments) ( 1, 2). The talocrural joint is the junction of three bony structures: the distal ends of the tibia and fibula and the trochlea of the talus. This article is mainly concerned with fractures and therefore does not contain a detailed discussion of ligamentous injuries. It also includes an overview and assessment of the various treatment options on the basis of selected articles from the literature. This review should enable readers to recognize and classify the different types of ankle fracture reliably and to pursue the proper further diagnostic evaluation for each type. ![]() The goal of treatment is to enable the patient to put his or her full weight on the joint once again without pain and to prevent permanent damage. The proper treatment is chosen on the basis of the mechanism of the accident and the correct classification of the injury and accompanying soft-tissue damage. For a good long-term functional outcome to be achieved, reliable early evaluation is crucial so that it can be determined whether the problem is a distorsion (sprain), ligament rupture, bony ligament avulsion, or fracture of the talocrural joint. The evidence level for optimal treatment strategies is low.įractures of the ankle joint are among the commonest fractures in adults, with an incidence of up to 174 cases per 100 000 persons per year ( 1). The long-term objective is to prevent post-traumatic ankle arthrosis. Up to 10% of patients develop ankle arthrosis over the intermediate or long term.Ĭonclusion: With properly chosen treatment, a good clinical outcome can be achieved. Wound hematoma and wound-edge necrosis are the most common complications, and the postoperative infection rate is 2%. An evaluation of the stability of the syndesmosis is important for anatomical reconstruction of the joint. Weber A fractures can usually be treated conservatively, while Weber B and C fractures are usually treated with surgery. Dislocated fractures need emergency treatment with immediate reduction this is crucial for the prevention of hypoperfusion and nerve damage. They can be classified according to either the AO Foundation (Association for the Study of Internal Fixation) or the Weber classification. Results: Ankle fractures are initially evaluated by physical examination and then by x-ray. Method: Selective review of the literature. Their correct classification and treatment are of decisive importance for clinical outcome. Background: Ankle fractures are common, with an incidence of up to 174 cases per 100 000 adults per year.
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