As stated above, the ankle is composed of the tibia, fibula, and talus articulating with each other, and these articulations are supported by strong ligamentous support on either side. The ankle joint is in the mortise and tenon joint classification. Also, assess if there are any signs of open wounds or compartment syndrome. Examine both the active and passive range of motion of the joint, as well as weight-bearing status. The clinician must ensure that the foot and ankle's neurovascular state is intact, including palpating pedal pulses and assessing the motor function, sensation, capillary refill time, and pulses at the injury site. The inability to bear weight on the injured foot indicates a fracture, and palpation can identify the fracture's exact location. It is also important to examine the knee, fibula, tibia, ankle, and foot and look for any signs of fracture like swelling, redness, hematoma formation, and lateral or medial tenderness malleolus or the proximal head of the fibula.
#Pain intermittently lateral malleolus fracture skin#
On physical examination, the clinician should begin with the affected limb by examining for gross deformity and skin changes that may indicate a change in neurovascular status or open wounds that may indicate an open fracture. Higher levels of force should raise the suspicion of more complications. It can be helpful if the patient is able to describe the injurious event and the force directed toward the ankle, along with the intensity of this force. The patient history should investigate multiple aspects of the injury, including time from injury to presentation, pain location, and possibly the mechanism of injury. So, it is necessary to ask about medication history. These should be identified before any physical exam takes place. Chronic medications such as corticosteroids can also cause prolonged healing. Important findings will include diabetes with or without peripheral neuropathy, peripheral vascular disease, osteopenia, alcohol use, tobacco use, and malignancy. History and PhysicalĪ focused and thorough history should be obtained to identify any comorbidities or conditions that may be detrimental to healing. Also, this is the third most frequent fracture in patients over 60 years of age. Ankle fracture is the third most common fracture overall in athletes, it is the most frequently encountered fracture. This fracture has a bimodal distribution and most commonly affects older women and young males. The bimalleolar fracture accounts for 60% of all ankle fractures, with an incidence of 187 fractures per 100,000 people. In the United States, ankle fractures are the most common lower limb fractures and are the most frequent fracture or injury in the emergency room. EpidemiologyĪnkle fractures account for 9% of all fractures. Eversion is considered the most common reason which can cause all damage. EtiologyĪccording to the Lauge Hansen classification: supination and external rotation injuries are the most common cause of bimalleolar fractures. Damage to the ligaments, instead of a fracture of one of the malleoli, still produces an unstable fracture that will likely need surgical intervention. Bimalleolar fractures can affect these ligaments, too. The ankle is supported by ligaments on both the medial and lateral sides that stabilize the foot under the leg and lock the fibula and tibia together. These two bones articulate with the talus to form the ankle or tibiotalar joint. Outline some interprofessional team strategies for improving care coordination and communication to advance bimalleolar fractures and improve outcomes.īimalleolar fractures are a type of ankle fracture that involve both the lateral and medial malleoli at the distal ends of the fibula and tibia, respectively.Summarize the management options available for bimalleolar fractures.
Review the appropriate process for the evaluation of bimalleolar fractures.Identify the etiology of bimalleolar fractures.This activity reviews the evaluation and management of bimalleolar fractures and studies the interprofessional team's role in evaluating and treating patients. Surgery is the primary treatment of bimalleolar fracture because it is an unstable fracture. This fracture is a bimodal distribution, most likely to affect older women and young males and those over 60 years old. Bimalleolar fractures are a type of ankle fracture that involve both the lateral and medial malleoli at the distal ends of the fibula and tibia, respectively.
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