Trimalleolar Fracture
History of present illness: A 35-year-old female presented to the emergency department (ED) with a chief complaint of right ankle pain after a mechanical fall. She complained of intermittent right foot numbness but otherwise denied any numbness or weakness to the right lower extremity. On examinati...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2016-09-01
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| Series: | Journal of Education and Teaching in Emergency Medicine |
| Subjects: | |
| Online Access: | http://jetem.org/trimalleolar-fracture/ |
| _version_ | 1818322555205844992 |
|---|---|
| author | Christopher Gilani Shannon Toohey |
| author_facet | Christopher Gilani Shannon Toohey |
| author_sort | Christopher Gilani |
| collection | DOAJ |
| description | History of present illness:
A 35-year-old female presented to the emergency department (ED) with a chief complaint of right ankle pain after a mechanical fall. She complained of intermittent right foot numbness but otherwise denied any numbness or weakness to the right lower extremity. On examination the right ankle was diffusely tender to palpation. She had normal motor function, normal distal pulses, and toes were warm and well perfused. Radiograph imaging was obtained.
Significant findings:
Anteroposterior (AP), lateral, and oblique x-ray views were obtained. The AP view revealed a displaced spiral fracture of the lateral malleolus (red) and a vertical fracture of the medial malleolus (blue). The lateral view revealed a displaced fracture of the posterior malleolus, tibial plafond (yellow), and the oblique view showed widening of the distal tibiofibular syndesmosis (green). CT scans confirmed trimalleolar fracture, annotated with the same colored lines (red, lateral malleolus; blue, medial malleolus; yellow, posterior malleolus).
Discussion:
Ankle fractures are a common problem encountered in the ED. The majority of ankle fractures involve the malleolus: 66% are unimalleolar, 25% are bimalleolar, and 7% are trimalleolar.1-4 In the evaluation of a patient with ankle pain, physicians should ensure that there is no associated neurovascular compromise. Physicians may use the Ottawa ankle rules to determine if radiography is necessary.3 If a trimalleolar fracture is found, an orthopedic surgeon should be consulted to schedule open reduction and internal fixation (ORIF) surgery.4 |
| first_indexed | 2024-12-13T10:58:39Z |
| format | Article |
| id | doaj.art-7d46767b4dbc4e5f9432469dd9d0bc6e |
| institution | Directory Open Access Journal |
| issn | 2474-1949 2474-1949 |
| language | English |
| last_indexed | 2024-12-13T10:58:39Z |
| publishDate | 2016-09-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Journal of Education and Teaching in Emergency Medicine |
| spelling | doaj.art-7d46767b4dbc4e5f9432469dd9d0bc6e2022-12-21T23:49:22ZengeScholarship Publishing, University of CaliforniaJournal of Education and Teaching in Emergency Medicine2474-19492474-19492016-09-0112V5V6doi:10.21980/J8PP46Trimalleolar FractureChristopher Gilani0Shannon Toohey1University of California, IrvineUniversity of California, IrvineHistory of present illness: A 35-year-old female presented to the emergency department (ED) with a chief complaint of right ankle pain after a mechanical fall. She complained of intermittent right foot numbness but otherwise denied any numbness or weakness to the right lower extremity. On examination the right ankle was diffusely tender to palpation. She had normal motor function, normal distal pulses, and toes were warm and well perfused. Radiograph imaging was obtained. Significant findings: Anteroposterior (AP), lateral, and oblique x-ray views were obtained. The AP view revealed a displaced spiral fracture of the lateral malleolus (red) and a vertical fracture of the medial malleolus (blue). The lateral view revealed a displaced fracture of the posterior malleolus, tibial plafond (yellow), and the oblique view showed widening of the distal tibiofibular syndesmosis (green). CT scans confirmed trimalleolar fracture, annotated with the same colored lines (red, lateral malleolus; blue, medial malleolus; yellow, posterior malleolus). Discussion: Ankle fractures are a common problem encountered in the ED. The majority of ankle fractures involve the malleolus: 66% are unimalleolar, 25% are bimalleolar, and 7% are trimalleolar.1-4 In the evaluation of a patient with ankle pain, physicians should ensure that there is no associated neurovascular compromise. Physicians may use the Ottawa ankle rules to determine if radiography is necessary.3 If a trimalleolar fracture is found, an orthopedic surgeon should be consulted to schedule open reduction and internal fixation (ORIF) surgery.4http://jetem.org/trimalleolar-fracture/Ankle fracturetrimalleolar fractureorthopedicsorthomusculoskeletal |
| spellingShingle | Christopher Gilani Shannon Toohey Trimalleolar Fracture Journal of Education and Teaching in Emergency Medicine Ankle fracture trimalleolar fracture orthopedics ortho musculoskeletal |
| title | Trimalleolar Fracture |
| title_full | Trimalleolar Fracture |
| title_fullStr | Trimalleolar Fracture |
| title_full_unstemmed | Trimalleolar Fracture |
| title_short | Trimalleolar Fracture |
| title_sort | trimalleolar fracture |
| topic | Ankle fracture trimalleolar fracture orthopedics ortho musculoskeletal |
| url | http://jetem.org/trimalleolar-fracture/ |
| work_keys_str_mv | AT christophergilani trimalleolarfracture AT shannontoohey trimalleolarfracture |