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Trimalleolar fx skin#
Trimalleolar fx full#

They can show where the bones are broken and if any of the bones are out of place (displaced). X-rays provide images of dense structures such as bone. X-rays. Most ankle fractures can be diagnosed with X-rays. If your doctor suspects an ankle fracture, they will order one or more of the following imaging tests to diagnose and evaluate the fracture (Simanski CJ, JOT 2006 20:108).After discussing your medical history and how the injury occurred, your doctor will do a careful examination of your ankle, lower leg, and foot. 100% good results Olerud score (90 +/- 13 points).

Trimalleolar fx full#

Average time to full weightbearing = 7weeks, return to work = 8weeks after surgery with early weight bearing protocol.

Smoking history, presence of a medial malleolar fracture, lower levels of education are significant independent predictors of lower physical function up to 3 months postoperation.

Physical function and role physical scores remain significantly lower than US norms at 24 months after operative fixation.

6 Months: Return to sport / full activities.

Running, stair-climbing, and participation in sports are allowed only after a full range of motion of the ankle has been achieved Rx=compression stocking (sigvaris, Jobst) 20-30mmHg Swelling is common after ankle sprain or fx. Driving: may drive after 9 weeks for right leg. Encourage daily active and passive range-of-motion exercises of the ankle and subtalar joints without the brace.

7-10 Days: Wound check, functional Air-Stirrup ankle brace (Aircast).

Post-op: bulky jones dressing, NWB, elevation.We discussed the risks of surgery including, but not limited to: incomplete relief of pain, incomplete return of function, nonunion, malnunion, painful hardware, hardware failure, compartment syndrome, CRPS, DVT/PE and the risks of anesthesia including heart attack, stroke and death.Peroneal tendon pathology: associated with low plate placement with a prominent screw head in the distal hole.Lateral malleolar fixation provided with posterior antiglide plate +/- lag screws.document osteochondral injuries which should be saught during ORIF.Prep and drape in standard sterile fashion.Well-padded tourniquet placed high on the thigh.Supine position with bump under ipsilateral hip.Pre-operative antibiotics, +/- regional block.FHL is medial and protects posterior tibial artery/nerve. Find interval between FHL and peroneal tendons. Incision between Achilles and peroneal tendons.

Posterior approach only needed for large posterior malleolar fragments-prone position.Posterior malleolar fragments >25% of the plafond may be fixed via percutaneous clamp reduction through the medical mallellar fracture or direct reduction through a posterolateral or posteromedial approach.

Trimalleolar fx skin#

Delayed surgery done when blisters have resolved, skin wrinkles normally (average 14 days) has equivalent outcomes (Karges/Watson, JOT 1995 9:377). Ideally surgery is done before any true swelling or fracture blisters have developed.

Timing of surgery is dictated by the status of the soft tissues.

ORIF Ankle Fracture Pre-op Planning / Special Considerations

Soft tissue compromise - severe swelling.

Lateral malleolus fracture with syndesmosis injury.

Lateral malleolus fracture with tibio-talar instability.

Synonyms: ORIF Ankle Fracture, open reduction internal fixation ankle, medial malleolus ORIF, lateral malleolus ORIF