Ankle fracture

Introduction to ankle fracture Ankle fracture is the most common intra-articular fracture. Mostly caused by indirect external force, very few caused by longitudinal extrusion. Intra-articular fractures require anatomical or near-anatomical fixation. In addition, ankle fractures often occur with ankle dislocation or subluxation. The articular surface of the ankle joint is smaller than the articular surface of the hip and knee joint, and the weight and activity of the ankle joint are large, so it is prone to damage. It accounts for 3.83% of total body fractures. More common in adolescents, improper treatment will be complicated by traumatic arthritis. basic knowledge The proportion of illness: 0.025% Susceptible people: more common in teenagers Mode of infection: non-infectious Complications: Traumatic arthritis

Cause of ankle fracture

External force factor (80%)

Fractures occur in areas that are far from violent, and do not occur where violence directly affects. A fracture is caused by violence through conduction, leverage or rotation. For example, an ankle fracture is a fracture caused by an accidental fall of a wounded person while walking.

Physical factors (10%)

Longitudinal compression fractures of the ankle were comminuted at the lower end of the humerus, compression fracture, dislocation of the ankle joint, fracture of the lower part of the humerus, dislocation, and sometimes injury of the lower tibiofibular ligament. The normal anatomical relationship of the ankle was severely damaged and the ankle was unstable.

Pathogenesis

First, the varus (adduction) type of fracture can be divided into III degrees.

I degree: simple internal malleolus fracture, the fracture edge from the lower tibial articular surface is upward and upward, close to the vertical direction.

II degree: The violence is relatively large. At the same time as the impact fracture of the internal hemorrhoid, the avulsion fracture occurs in the lateral malleolus.

III degree: the violence is large, the internal and external iliac fractures and the talus backward impact on the posterior border of the humerus, and the posterior malleolar fracture (three fractures).

Second, the valgus (outreach) type of fracture can be divided into III degrees according to the degree of fracture.

I degree: simple internal avulsion fracture, the fracture line is horizontal or short oblique, the fracture surface is coronal, and not displaced.

II degree: the violence continues to work, the talar body slams outward, and the external sacral fracture occurs, that is, the double sacral fracture. If the internal iliac fracture is accompanied by the rupture of the infraorbital ligament, the lower end of the humerus can be separated, and the talus is displaced outward. At the lower end of the humerus, it is equivalent to the upper ligament, forming a torsional external force, causing a fracture of the lower third or middle third of the humerus, called Dupuytren fracture.

III degree: excessive violence, the talus impacts the posterior margin of the lower humerus articular surface, and the posterior malleolar fracture occurs, that is, the three-ankle fracture.

Third, external rotation fracture: occurs when the calf does not move the foot strong external rotation, or the foot does not move the calf strong inward rotation, the anterior lateral part of the talus squeezes the anterior medial lateral malleolus, causing the lower end of the humerus oblique or spiral fracture can also be divided into III degree.

I degree: the fracture displacement is less. If there is displacement, the distal fracture end is outward, and rotates backward and outward.

II degree: greater violence, internal ligament rupture or internal avulsion fracture, that is, double hernia fracture.

III degree: strong violence, the talus is displaced to the outside, and rotates outward. After the impact, three fractures occur.

Fourth, longitudinal extrusion fracture: falling from a height, vertical landing of the heel, can cause fracture of the anterior border of the humerus, with the ankle joint dislocation forward, if the violence is too large, can cause comminuted fracture of the lower humerus articular surface.

In the case of severe trauma, when a three-fold fracture occurs, the ankle joint completely loses stability and undergoes significant dislocation, which is called a Pott fracture.

Ankle fracture prevention

The disease usually occurs in traumatic patients, with more young athletes, ankle fractures as intra-articular fractures, often with ankle dislocation. Treatment requires fracture anatomy or near anatomical reduction. The subluxation should be corrected. Otherwise, the joint will be unstable, or the joint surface will be not smooth, resulting in traumatic arthritis, affecting life and work. Such fractures should go to the hospital and ask the orthopedic doctor to treat them promptly.

Ankle fracture complications Complications, traumatic arthritis

In the ankle fracture, especially after the oblique fracture or spiral fracture of the humerus, the patella can be shortened, the talus is tilted, the joint disorder is changed, and the function recovery after the external hemorrhoid injury varies with the reset, and the disease The most common complication is traumatic arthritis. When the patient is injured, the lateral malleolus is displaced 2 mm outward, and the talus is also displaced 1 to 2 mm outward, and the talus is 1 to 2°. The joint contact surface was reduced by 51%. Ram sey pointed out that the talus movement caused the change of the joint surface of the sacral joint. When the talus moved outward by 1 mm, the joint surface of the sacral joint was reduced by 42%. With the increase of the distance of the external movement, the contact surface gradually decreased. The increase in local pressure is the main cause of advanced traumatic arthritis.

In addition, the ankle fracture is an intra-articular fracture, often accompanied by ankle dislocation, treatment requires fracture anatomy or near anatomical reduction, subluxation should be corrected, otherwise it will cause joint instability, or because the joint surface is not smooth, can also lead to traumatic Arthritis, affecting life and work, such fractures should go to the hospital and ask the orthopedic doctor to treat them promptly.

Ankle fracture symptoms Common symptoms Ankle pain Ankle swelling Sputum and foot edema Internal and inferior region Pain swelling Foot and ankle injury Ankle flexion contracture deformity Adduction fracture Knee joint effusion

After ankle injury, local swelling is obvious, ecchymosis, varus or valgus deformity, activity disorder, examination can be more localized tenderness at the fracture site, the ankle joint is positive, and the lateral X-ray film can identify the fracture site. Type, displacement direction, for type III fractures, the full length of the humerus should be examined. If there is local tenderness, X-ray films should be taken to confirm the diagnosis of high tibial fracture.

Ankle fracture examination

X-ray and CT examination are conducive to the diagnosis of this disease:

1, X-ray inspection:

For stress fractures, X-ray films show osteocortical rupture, and some periosteal thickening can be seen; if the early fracture is limited to the cortical bone, or the periosteal thickening is not obvious, X-ray plain film is easy to miss diagnosis, X-ray film only It can be found that its large avulsion bones, but the tiny avulsion bones are powerless. The hematoma around the joints and the fluid in the joint cavity, blood accumulation, and X-ray film of the ganglion cyst are also difficult to find.

2, CT examination:

The high resolution of CT scan can clearly show the cortical bone fracture and trabecular bone walking. A slight periosteal reaction can also show that CT scan can clearly show the joint capsule fluid and ganglion cyst and tiny avulsion bone block caused by fracture. So that the clinician can dispose of it in time.

Diagnosis and diagnosis of ankle fracture

In the diagnosis of this disease, the mechanism of injury should be analyzed based on the history of trauma and clinical symptoms and the type of fracture shown by X-ray films.

Diagnose based on

1. There is a clear history of trauma.

2. The above symptoms and signs, such as swelling and pain, deformity and so on.

3. X-ray film can be seen fracture.

The disease is mainly caused by traumatic factors. When fractures of the ankle are often accompanied by other fractures and injuries, the clinical diagnosis should be differentiated from the following diseases:

1. Sprained ankle;

2, fracture of the tibia;

3, the middle foot sprain and so on.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.