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Ankle Fracture Dislocations

- Treatment Considerations:
    - it is essential to reduce the dislocation in the ER, so as to avoid tenting of the skin over the anterior tibia;
    - w/ a trimalleolar frx-dislocation, consider a posterior approach using an antiglide plate and fixation of the posterior malleolar fragment (which can be accomplished through the posterior incision);
    - in absence of a medial malleolar frx, routine exploration of medial side of the ankle is not necessary unless there is evidence that portion of the deltoid ligament or the tibialis posterior has entered the joint and is blocking reduction of the talus;

- Case Examples:


Surgical treatment of fracture-dislocations of the ankle joint with biodegradable implants: a prospective randomized study.

Anterior ankle dislocation with associated trigonal process fracture.  A case report and literature review.

Fracture-dislocation of the ankle with posterior entrapment of the fibula behind the tibia.

Laterally comminuted fracture-dislocation of the ankle.

Operative treatment of ankle fracture-dislocations. A follow-up study of 306/321 consecutive cases.

Posteromedial dislocation of the ankle without fracture.

Intra-Articular Block Compared with Conscious Sedation for Closed Reduction of Ankle Fracture-Dislocations

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