Case for small group discussion Ankle fracture Case for small group discussion AOTrauma—Foot & Ankle Module 1a: Ankle trauma—ankle fractures Stefan Rammelt, DE

Case description 38-year-old patient fell from a ladder Minimal soft-tissue swelling Closed fracture Treatment options? Timing? To discuss – is this a satisfactory fixation?

Postoperative x-rays Internal fixation performed Comments? To discuss – is this satisfactory fixation? Is more information needed? Position of syndesmotic screw Not enough compression medially?

Analysis

Now what?

Correction

Take-home messages Exact reduction of fibula into the tibial incisura Direct vision of the syndesmosis Essential to analyze the radiological landmarks to check the reduction Check with postoperative CT scan or intraoperative 3-D fluoroscopy Early correction to correct malreduction is required