![]() Pilon fracture usually results from high energy axial loading trauma, e.g., fall from a high distance causing impaction of the talus against the tibial plafond. This injury is the comminuted fracture of the tibial plafond (distal end of the tibia, including the articular surface). This unstable injury requires operative treatment. ![]() Maisonneuve injury combines a proximal fibular fracture with tibiofibular syndesmosis and deltoid ligament injury with or without medial malleolus fracture. It is an unstable ankle injury caused by pronation external rotation injury. Injuries always occur in a cumulative pattern for example, a SER4 injury includes injuries of SER1, SER2, and SER3. Ĭomminuted or transverse fibular fracture (proximal to tibial plafond) Branches from the peroneal, anterior, and posterior tibial arteries provide the arterial supply to the ankle joint. The ankle joint is innervated by articular branches from the tibial nerve, superficial and deep peroneal nerves. The lateral ligament complex resists the ankle from over the inversion. The lateral ligaments complex consists of three ligaments originating from the lateral malleolus and attaches to the talus (anterior and posterior talofibular ligaments) and the calcaneus(calcaneofibular ligament). The deltoid ligament originates from the medial malleolus and attaches to the talus, navicular, and calcaneus bones and stabilizes the ankle joint against over eversion. The syndesmosis is formed by three main parts the interosseous tibiofibular ligament, the anterior inferior tibiofibular ligament, and the posterior inferior tibiofibular ligament. The ankle syndesmosis is a fibrous joint connecting the distal tibia and fibula. The ankle joint entires three malleoli the lateral malleolus (distal end of the fibula), medial malleolus (medial lower end of the tibia), and the posterior malleolus.Īnkle joint stability is provided by the ankle mortise articulation with the talus body, the ankle syndesmosis, the ligaments and muscles around the ankle joint. The distal tibia and fibula articular portions together form the ankle mortice, which contains the body of talus bone. It is formed by the articulation between three bones distal tibia, distal fibula, and talus bone. The ankle joint is a hinge synovial joint that moves in one plane to produce dorsiflexion and plantar flexion. Treatment of these fractures aims to restore joint stability and alignment to reduce the risk of post-traumatic ankle arthritis. 1992 Sep 13(7):404-7.Ankle fractures are common injuries that could result from a trivial twisting injury in old frail patients up to high energy trauma in a young population. Harper MC: Ankle fracture classification systems: a case for integration of the Lauge-Hansen and AO-Danis-Weber schemes Foot Ankle.Arimoto HK, Forrester DM: Classification of ankle fractures: an algorithm AJR Am J Roentgenol.Wheeless' Orthopedics: discussion of Weber B fractures.The fracture is seen to arise at the same level of the tibiotalar joint, indicative of a Weber B injury. There is a fibular fracture, near the level of the tibiotalar joint. This results in partial disruption of the tibiofibular ligament complex and is from supination-lateral rotation injury. The Weber B fracture consists of a fracture of the fibula near the joint and a transverse fracture of the medial malleolus (or disruption of the deltoid ligament). The Weber classification is used to determine the severity of tibiofibular ligament injury by the level of fibular fracture.
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