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Year |
2001 |
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Question Number |
202. |
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Category |
Select |
Question
An ankle fracture heals with an anatomically aligned mortise and 2 mm of displacement of the distal fibula fracture. What affect will these findings have on the tibiotalar joint?
1- Decreased contact loading
2- Increased contact loading
3- Increased external rotation
4- Increased mediolateral translation
5- Normal loading, rotation and translation
Figures
Answer (click for answer)
Answer 5.
In regards to isolated lateral malleolus fractures recent biomechanical and computed tomography investigations have shown that despite up to 3 mm of lateral malleolar displacement no changes occur in the loading characteristics or motion of the ankle. In several studies, the outcome of anatomic reduction and internal fixation was similar to that of non-surgical treatment of lateral malleolar fractures with up to 3 mm displacement. These findings suggest that up to 3 mm of displacement of the lateral malleolus, with anatomic reduction of the talus (anatomic aligned mortise), can be treated non-surgically.
Reference: Brown TD, Hurlbut PT, Hale JE, et al: Effects of imposed hindfoot constraint on ankle contact mechanics for displaced lateral malleolar fractures. J Orthop Trauma 1994;8:511-519
Michelson JD: Fractures about the ankle. J Bone Joint Surg Am 1995;77:142-152
Michelson JD, Magid D, Ney DR, Fishman EK: Examination of the pathologic anatomy of ankle fractures. J Trauma 1992; 32: 65-70