- Ankle surgery open reduction internal fixation driver#
- Ankle surgery open reduction internal fixation skin#
A reduction was successfully performed in the ED under conscious sedation and was stabilized temporarily using a well-padded posterior splint. He was found to have a trimalleolar ankle fracture with associated lateral dislocation. The patient received adequate analgesia, and ankle x-rays were obtained. Intact sensation was reported in both lower limbs however muscle strength could not be assessed on the injured side because of pain. The right foot was pink with rapid capillary refill however, the right pedal pulses were not palpable.
Ankle surgery open reduction internal fixation skin#
The secondary survey was significant for a grossly deformed right ankle with medial skin tenting and bruising however, no open wounds were identified. His airway and cervical spine, breathing, circulation, and neurologic status were all sequentially evaluated and cleared. Initial evaluation followed the advanced trauma life support protocol. His vital signs were all within normal limits. Apart from his ankle, the patient had no complaints. On arrival at the ED, he was conscious and alert with a Glasgow coma scale of 15.
Ankle surgery open reduction internal fixation driver#
7,8,9,10 Focused History of the PatientĪ previously healthy 23-year-old male presented to the emergency department (ED) complaining of severe right ankle pain, swelling, and deformity after being a restrained driver in a head-on motor vehicle collision. 4,5,6 The relationship between ankle fractures and osteoporosis is less clear while some studies identified ankle fractures as osteoporotic, others failed to identify any significant relationship between bone mineral density measurements and such injuries. There are several risk factors for ankle fractures, including obesity, multiple falls, and alcohol consumption. 3 Men are more likely to sustain ankle fractures at younger ages than are women. 1,2 High-energy trauma can also result in ankle fractures, commonly with suprasyndesmotic patterns. Elderly women are especially susceptible to these injuries, reporting the highest incidence of ankle fractures, particularly bimalleolar and trimalleolar patterns. Low-energy trauma accounts for the majority of ankle fractures. Because the joints in the lower limb act in concert during the gait cycle, any deviation from the normal function of one joint can have significant implications on the function of the other joints.
Disregarding the precise details of these fractures can lead to disappointing outcomes. Case Overview BackgroundĪnkle fractures are among the most commonly encountered fractures in orthopedics nevertheless, their frequency should not undermine their seriousness. Weaver discusses the surgical landmarks and approaches to the ankle, the methods of fixing the malleoli and the syndesmosis, and common concerns that arise during the surgical management of ankle fractures. Weaver walks us through the surgical management of a 23-year-old male who sustained a trimalleolar ankle fracture with concomitant dislocation and syndesmotic injury following a motor vehicle collision. Operative management is recommended for most displaced fractures, fractures with dislocations, and open fractures. 1, 2 The goal of management is to restore a stable and congruent joint. Ankle fractures are the second most common lower limb fractures after those involving the hip, accounting for 10% of all fractures, with an incidence that has been increasing.
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