Regional Traumatology :

The Ankle

By Niroshni and Rajalakshmi

CONTENT
• TALUS FRACTURE
• MALLEOLAR FRACTURE
Anatomy
 Diagnostic Procedures

X RAY

CT

MRI
TALUS FRACTURES
Neck
• Undisplaced
• Displaced
• Multifragment

Body
• Body

Process
• Lateral
• Posterior
Mechansim: Most talus fractures are the result of high-energy trauma such
as a car collision or a fall from height. Injuries from sports, particularly
snowboarding, are another, though less common, cause of talus injuries.
The most common symptoms of a talus fracture include severe ankle pain
and swelling. Other symptoms may include:
• Difficulty walking.
• Inability to place weight on your foot.
• Bruising.
• Tenderness.
• Fracture blisters (fluid-filled blisters on your skin).
• Deformity(if displaced)
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 NECK OF TALUS FRACTURE

Multifragmented Fracture

• Fractures caused by axial load and a dorsiflexed

foot

• Results in soft tissue and open talar injuries

 Undisplaced Fracture

• Fractures are Uncommon

• Talar neck fracture is undisplaced and
all joint surfaces are in perfect
alignment

Increasing displacement presupposes that

there is more subtalar and tibiotalar
osteochondral injury.
 TREATMENT METHODS
Undisplaced Fractures Displaced Fractures Multifragmentary
Fractures
1) Non-operative Treatment: 1)Closed reduction:
• non weightbearing below- 1) ORIF- Plate Fixation
Type 1,Type 2 hawkins
the-knee plaster cast for 6-
8weeks 2)ORIF: screw fixation
• Once out of plaster,
Type 3 ,4 hawkins
mobilization is started and
gait training is initiated
with physiotherapy.
 ORIF- Screw Fixation

ORIF- Plate Fixation

 Body of Talus Fracture
• The talar body has an
extremely compromised
blood supply

Treatment:
ORIF- Screws and Plate Fixation

Complication :
Avascular necrosis
 PROCESS FRACTURES
Lateral Process Fracture

• Snowboarder’s Fracture
•Forced Plantarflexion &
• Forced Eversion & Compromised Compromised articular
articular surface of subtalar joint surface of subtalar joint

• often confused with an ankle sprain

 TREATMENT METHODS
Lateral Process Fractures Posterior Process
Fractures

1) ORIF- Screw Fixation 1) ORIF- Screw Fixation

 MALLEOLAR FRACTRURES

• Isolated lateral malleolar fractures

• Isolated medial malleolar fractures
• Bimalleolar fractures ( = medial + lateral
malleolar fracture)- 20%
• Trimalleolarfractures ( = medial + lateral +
posterior malleolar fracture)-10%
MECHANISM- Twisting or rotating of the ankle
from a standing position.

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DANIS WEBER CLASSIFICATION

A – INFRASYNDESMOTIC

B- TRANSSYNDDESMOTIC

C- SUPRASYNDESMOTIC
 TREATMENT
Conservative management will often be opted for in:
• Non-displaced isolated malleolus fractures
• Weber A fractures or Weber B fractures without talar shift
• Those unfit for surgical intervention
Surgical Management
Open reduction and internal fixation (ORIF) is often required in ankle fractures
to achieve stable anatomical reduction of the talus within the ankle mortise. 
Ankle fractures that require an ORIF include:
• Displaced bimalleolar or trimalleolar fractures
• Weber C fractures
• Weber B fractures with talar shift 16
Lag screw fixation

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Thank you