Fractures of the ankle joint: investigation and treatment options.
- Goost H Department of Orthopedic and Trauma Surgery, University Hospital Bonn, Orthopedic Department at the University Hospital of Basel, Switzerland, HG and MDW have equally contributed to the manuscript.
- Wimmer MD
- Barg A
- Kabir K
- Valderrabano V
- Burger C
- 2014-06-19
Published in:
- Deutsches Arzteblatt international. - 2014
Ankle Fractures
Combined Modality Therapy
Diagnostic Imaging
Foot Orthoses
Fracture Fixation
Humans
Physical Examination
Physical Therapy Modalities
Severity of Illness Index
English
BACKGROUND
Ankle fractures are common, with an incidence of up to 174 cases per 100 000 adults per year. Their correct classification and treatment are of decisive importance for clinical outcome.
METHOD
Selective review of the literature.
RESULTS
Ankle fractures are initially evaluated by physical examination and then by x-ray. They can be classified according to either the AO Foundation (Association for the Study of Internal Fixation) or the Weber classification. Dislocated fractures need emergency treatment with immediate reduction; this is crucial for the prevention of hypoperfusion and nerve damage. Weber A fractures can usually be treated conservatively, while Weber B and C fractures are usually treated with surgery. An evaluation of the stability of the syndesmosis is important for anatomical reconstruction of the joint. Wound hematoma and wound-edge necrosis are the most common complications, and the postoperative infection rate is 2%. Up to 10% of patients develop ankle arthrosis over the intermediate or long term.
CONCLUSION
With properly chosen treatment, a good clinical outcome can be achieved. The long-term objective is to prevent post-traumatic ankle arthrosis. The evidence level for optimal treatment strategies is low.
Ankle fractures are common, with an incidence of up to 174 cases per 100 000 adults per year. Their correct classification and treatment are of decisive importance for clinical outcome.
METHOD
Selective review of the literature.
RESULTS
Ankle fractures are initially evaluated by physical examination and then by x-ray. They can be classified according to either the AO Foundation (Association for the Study of Internal Fixation) or the Weber classification. Dislocated fractures need emergency treatment with immediate reduction; this is crucial for the prevention of hypoperfusion and nerve damage. Weber A fractures can usually be treated conservatively, while Weber B and C fractures are usually treated with surgery. An evaluation of the stability of the syndesmosis is important for anatomical reconstruction of the joint. Wound hematoma and wound-edge necrosis are the most common complications, and the postoperative infection rate is 2%. Up to 10% of patients develop ankle arthrosis over the intermediate or long term.
CONCLUSION
With properly chosen treatment, a good clinical outcome can be achieved. The long-term objective is to prevent post-traumatic ankle arthrosis. The evidence level for optimal treatment strategies is low.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.3238/arztebl.2014.0377
- PMID 24939377
- Persistent URL
- https://sonar.ch/global/documents/232318
Statistics
Document views: 51
File downloads:
- Full-text: 0