Principles and guidelines in the management of ankle fractures in adults

Abstract

Ankle fractures are common injuries that have many physical and psychosocial complications. As a result, it is important to be aware of how these patients present and are managed perioperatively. Detailed guidelines from NICE and the British Orthopaedic Association have been produced on this topic, including recent developments such as the decision to weight-bear early after surgery and the use of virtual fracture clinics. This article provides an overview of the key perioperative factors that need to be considered in cases of ankle fracture and the relevant clinical guidelines.

Keywords: Ankle fracture; Complications; Orthopaedics; Perioperative.

Figure 1

Anatomy of the ankle. Right foot in various views: (a) lateral; (b) medial; (c) anterior; (d) posterior (a part of the Achilles tendon has been removed). The names of the corresponding ligaments are given in blue.

Figure 2

The Danis–Weber classification system. Right foot viewed posteriorly: (a) Type A; (b) Type B; (c) Type C with disrupted syndesmosis.

Figure 3

Open reduction and internal fixation. Mortise view of an unstable lateral and medial malleolar ankle fracture before surgery (a) and after ORIF (b).