• Hans Goost, Matthias D Wimmer, Alexej Barg, Kouroush Kabir, Victor Valderrabano, and Christof Burger.
• Department of Orthopedic and Trauma Surgery, University Hospital Bonn, Orthopedic Department at the University Hospital of Basel, Switzerland, HG and MDW have equally contributed to the manuscript.
• Dtsch Arztebl Int. 2014 May 23; 111 (21): 377-88.

BackgroundAnkle fractures are common, with an incidence of up to 174 cases per 100 000 adults per year. Their correct classification and treatment are of decisive importance for clinical outcome.MethodSelective review of the literature.ResultsAnkle fractures are initially evaluated by physical examination and then by x-ray. They can be classified according to either the AO Foundation (Association for the Study of Internal Fixation) or the Weber classification. Dislocated fractures need emergency treatment with immediate reduction; this is crucial for the prevention of hypoperfusion and nerve damage. Weber A fractures can usually be treated conservatively, while Weber B and C fractures are usually treated with surgery. An evaluation of the stability of the syndesmosis is important for anatomical reconstruction of the joint. Wound hematoma and wound-edge necrosis are the most common complications, and the postoperative infection rate is 2%. Up to 10% of patients develop ankle arthrosis over the intermediate or long term.ConclusionWith properly chosen treatment, a good clinical outcome can be achieved. The long-term objective is to prevent post-traumatic ankle arthrosis. The evidence level for optimal treatment strategies is low.

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