The Orthobullets Podcast Coinflips⎪Trauma⎪Ankle Fracture in 45F
Jul 16, 2025
Landon Fine, an orthopedic trauma surgeon from Parker, Colorado, and Lauren Crocco, a trauma surgeon from Montefiore Einstein in the Bronx, dive into the complexities of ankle fractures. They dissect a case of a 45-year-old woman injured in a vehicular accident. Their discussion covers crucial surgical decisions, imaging techniques, and the nuances of managing bimalleolar fractures. They explore fixation methods, including the use of screws and clamps, while weighing the pros and cons of early versus cautious post-operative weight-bearing strategies.
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Operative Treatment for Unstable Ankles
- Unstable ankle fractures in healthy patients are almost always treated operatively.
- Non-operative management might be considered only in very sick or bedbound patients where surgery is risky.
Proper Splinting Technique
- Achieve a good closed reduction with proper splinting, avoiding excess plantarflexion.
- A gentle banana-shaped bend in the splint is key to maintain reduction in ankle fractures.
Lauge-Hansen Classification Utility
- Lauge-Hansen classification is useful to understand injury mechanisms but not critical for treatment decisions.
- The fibula fracture level helps differentiate supination-external rotation from pronation injuries.