![]() ![]() However, more severe injuries with ligamentous injury and ankle instability may require operative reduction and internal fixation.We aimed to evaluate the biomechanical stiffness and strength of different internal fixation configurations and find suitable treatment strategies for low transcondylar fractures of the distal humerus. The majority of injuries are relatively simple avulsion injuries from the fibular pole and only require immobilization with a cast. Treatment depends on the type of distal fibula fracture which is a reflection of the severity of the fracture and the surrounding ligamentous structures. This is called talar shift and the ankle joint is unstable. If they are not and the talar dome is not parallel to the tibial plafond, the syndesmosis has been torn. The joint spaces around the talus should be the same all the way around. whether there is another fracture (medial malleolus, talus).whether there is displacement (translocation, angulation, rotation).what type of fracture (transverse, oblique, spiral, comminuted).where the fracture is in the bone (relative to syndesmosis).Once you have seen the fracture, remember to describe: Remember that avulsion injuries may be small, and just involve the tip, or the internal surface of the malleolus. ![]() If there is a lot of soft tissue swelling over the lateral malleolus, but no fracture, then there has been a ligamentous injury. The AP and lateral views from an ankle x-ray will almost always allow detection of a lateral malleolar fracture. It is worth noting that fractures may be invisible on one projection. In most cases an ankle x-ray is all that is required for diagnosis and follow up. This results in widening of the distal tibiofibular joint and loss of integrity of the socket. In Weber B and C fractures the syndesmosis may have been torn (partially or completely).
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