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The bone & joint journal · Jul 2017
ReviewWhen is a simple fracture of the lateral malleolus not so simple? how to assess stability, which ones to fix and the role of the deltoid ligament.
- N Gougoulias and A Sakellariou.
- Frimley Health NHS Foundation Trust, Frimley Park Hospital, Portsmouth Road, Frimley, Surrey, GU16 7UJ, UK.
- Bone Joint J. 2017 Jul 1; 99-B (7): 851-855.
AbstractStable fractures of the ankle can be safely treated non-operatively. It is also gradually being recognised that the integrity of the 'medial column' is essential for the stability of the fracture. It is generally thought that bi- and tri-malleolar fractures are unstable, as are pronation external rotation injuries resulting in an isolated high fibular fracture (Weber type-C), where the deltoid ligament is damaged or the medial malleolus fractured. However, how best to identify unstable, isolated, trans-syndesmotic Weber type-B supination external rotation (SER) fractures of the lateral malleolus remains controversial. We provide a rationale as to how to classify SER distal fibular fractures using weight-bearing radiographs, and how this can help guide the management of these common injuries. Cite this article: Bone Joint J 2017;99-B:851-5.©2017 The British Editorial Society of Bone & Joint Surgery.
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