![]() This type of injury allows the talus to remain anatomically positioned within the mortise, preventing displacement of the joint. Ankle fractures are classified as stable if the fracture is non-displaced or minimally displaced and the medial structures (deltoid ligament and medial malleolus) are intact. Regarding the soft tissues, the single most important feature to note is whether the fracture is "open," that is, that the skin is broken.Īnother important consideration is the stability of the ankle joint (Figure 3). It may be best, therefore to describe ankle fractures by the bones involved (i.e., isolated medial/lateral malleolar, bimalleolar, trimalleolar, etc.) and the presence of absence of soft tissue injury. There are many methods of classifying ankle fractures: some are too simple (and therefore not very informative), and others provide more detailed information (yet become unwieldy and unreliable). The surface may crack and not bend in response to a new load. The loss of compliance makes the entire system more prone to damage. This new bone in turn makes the tissue below the cartilage more rigid (technically speaking less compliant). This is in accordance with Wolff's Law, which states that bone grows in response to load. Thus, a smaller area of contact for a given load leads to higher pressure. Recall that pressure is defined by the force (load) divided by area. This abnormal motion leads to focal pressure points which can be damaging. When the mortise is disrupted by a fracture, the talus is free to move more than it should. The anterior and posterior distal tibiofibular ligaments or syndesmosis, which connects the distal tibia and fibula above the tibio-talar joint line. ![]()
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