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Isolated posterior malleolus fracture: a rare injury mechanism.

Serbest S, Tiftikçi U, Tosun HB, Kesgin E, Karataş M - Pan Afr Med J (2015)

Bottom Line: Sprain of the ankle is undoubtedly a common injury during athletic activity, and the sprain can be also associated with fracture of the ankle.Here, we are presenting a 37 years old female patient, who suffered injury secondary pressing on brake pedal during collision in a traffic accident.This study aims to emphasize that Ottawa Ankle Rules are usually efficient for evaluating fractures of ankle, but clinicians should always make a detailed physical examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.

ABSTRACT
Sprain of the ankle is undoubtedly a common injury during athletic activity, and the sprain can be also associated with fracture of the ankle. Isolated posterior malleolus fracture is a very rare condition, which is usually missed. Here, we are presenting a 37 years old female patient, who suffered injury secondary pressing on brake pedal during collision in a traffic accident. Clinical evaluation is based on Ottawa Ankle Rules and a fracture is diagnosed; patient is started on daily activities at postoperative Week 8. This study aims to emphasize that Ottawa Ankle Rules are usually efficient for evaluating fractures of ankle, but clinicians should always make a detailed physical examination.

No MeSH data available.


Related in: MedlinePlus

Closed reduction and One compression screw was fasted at posteroanterior orientation and the fracture was fixed. Anteroposterior (a) and lateral X-ray of the ankle
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Figure 0003: Closed reduction and One compression screw was fasted at posteroanterior orientation and the fracture was fixed. Anteroposterior (a) and lateral X-ray of the ankle

Mentions: Wearing heals, the 37 years old female patient referred to Emergency room for pain in the right ankle secondary to pushing the brake pedal during a traffic accident. On the physical examination, patient was ambulatory, although minimal limping was observed in right lower limb, and no swelling was noted on the ankle. Local tenderness was not found at medial and lateral malleolar localizations. Fibular compression test was negative and no tenderness was palpated on the fibula. On baseline radiographies, no fracture was observed and soft tissue injury was considered (Figure 1). Patient referred to Orthopedics outpatient clinic 2 days later, since pain persisted at the ankle. Patient was examined again according to Ottawa criteria. In addition to findings identified above, patient could not walk even for 4 steps. Radiographies were re-evaluated. Computed tomography was scanned. A bone fragment with 25% separation was observed on the posterior malleolus and the fragment was also extending to articular surface (Figure 2). Spinal anesthesia was induced. One compression screw was fasted at posteroanterior orientation and the fracture was fixed (Figure 3). Ankle exercises were started at early postoperative course. Patient was mobilized with two crutches for 3 weeks without bearing load. Patient was allowed bearing load at Week 6, as long as patient could tolerate. Patient could be mobilized without crutches at Week 8. On final radiographies, union was verified and ROM of the ankle was intact (Figure 4). AOFAS (American Orthopedic Foot and Ankle Society) score was 96.


Isolated posterior malleolus fracture: a rare injury mechanism.

Serbest S, Tiftikçi U, Tosun HB, Kesgin E, Karataş M - Pan Afr Med J (2015)

Closed reduction and One compression screw was fasted at posteroanterior orientation and the fracture was fixed. Anteroposterior (a) and lateral X-ray of the ankle
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4462560&req=5

Figure 0003: Closed reduction and One compression screw was fasted at posteroanterior orientation and the fracture was fixed. Anteroposterior (a) and lateral X-ray of the ankle
Mentions: Wearing heals, the 37 years old female patient referred to Emergency room for pain in the right ankle secondary to pushing the brake pedal during a traffic accident. On the physical examination, patient was ambulatory, although minimal limping was observed in right lower limb, and no swelling was noted on the ankle. Local tenderness was not found at medial and lateral malleolar localizations. Fibular compression test was negative and no tenderness was palpated on the fibula. On baseline radiographies, no fracture was observed and soft tissue injury was considered (Figure 1). Patient referred to Orthopedics outpatient clinic 2 days later, since pain persisted at the ankle. Patient was examined again according to Ottawa criteria. In addition to findings identified above, patient could not walk even for 4 steps. Radiographies were re-evaluated. Computed tomography was scanned. A bone fragment with 25% separation was observed on the posterior malleolus and the fragment was also extending to articular surface (Figure 2). Spinal anesthesia was induced. One compression screw was fasted at posteroanterior orientation and the fracture was fixed (Figure 3). Ankle exercises were started at early postoperative course. Patient was mobilized with two crutches for 3 weeks without bearing load. Patient was allowed bearing load at Week 6, as long as patient could tolerate. Patient could be mobilized without crutches at Week 8. On final radiographies, union was verified and ROM of the ankle was intact (Figure 4). AOFAS (American Orthopedic Foot and Ankle Society) score was 96.

Bottom Line: Sprain of the ankle is undoubtedly a common injury during athletic activity, and the sprain can be also associated with fracture of the ankle.Here, we are presenting a 37 years old female patient, who suffered injury secondary pressing on brake pedal during collision in a traffic accident.This study aims to emphasize that Ottawa Ankle Rules are usually efficient for evaluating fractures of ankle, but clinicians should always make a detailed physical examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.

ABSTRACT
Sprain of the ankle is undoubtedly a common injury during athletic activity, and the sprain can be also associated with fracture of the ankle. Isolated posterior malleolus fracture is a very rare condition, which is usually missed. Here, we are presenting a 37 years old female patient, who suffered injury secondary pressing on brake pedal during collision in a traffic accident. Clinical evaluation is based on Ottawa Ankle Rules and a fracture is diagnosed; patient is started on daily activities at postoperative Week 8. This study aims to emphasize that Ottawa Ankle Rules are usually efficient for evaluating fractures of ankle, but clinicians should always make a detailed physical examination.

No MeSH data available.


Related in: MedlinePlus