6 - Ankle and Midfoot Fractures and Dislocations

Abstract

Fractures and dislocations of the ankle are among the most common injuries in the musculoskeletal system. Sports-related lower limb fractures and dislocation are particularly problematic for athletes because they often result in significant periods of non-weight rehabilitation. The disability and time away from sports resulting from these injuries warrant close attention to diagnosis and management. Stable ankle fractures are treated nonoperatively with good results in the majority of patients. Meticulous clinical and radiographic evaluation is necessary to determine which ankle fractures will require operative treatment. We present a practical approach to evaluation and management of the most common ankle fracture variants. We also offer an approach to the management of deltoid ligament injuries in association with ankle fractures, and discuss the role of adjunct treatments such as arthroscopic assisted ankle fracture treatment. Fractures of the lateral process of the talus and anterior process calcaneus fractures are often difficult to detect on radiographs and many times misdiagnosed as ankle sprains. These common sports related hindfoot fractures are discussed in detail, and we offer a simple approach for diagnosis and management of these injuries.