Ankle Archives : Page 2 of 3 : Wheeless' Textbook of Orthopaedics

AP of Ankle

– Discussion: – is taken in line with the long axis of the foot; – entire fibula should be included if there is lateral joint tenderness above the joint line; – this view is used to evaluate medial & lateral malleolus anterolateral tibia and proximal fibula; – osteochondral frx of distal tibia and talus; … Read more

Anterolateral Approach to the Ankle

– Discussion: – allows acces to ankle joint, talus, & other tarsal bones and joints; – it does not allow access to the navicular and 2nd and 1st cuniforms; – avoids all of the important vessels and nerves; – dissection procedes between the peroneus tertius (deep peroneal nerve) and the peroneus brevis (superficial peroneal … Read more

Anterior Impingement Syndrome of the Ankle

– Bony Impingement: – pts who have persistent pain in anterior aspect of ankle & who have anterior tibiotalar spur evident on a lateral roentgenogram need additional diagnostic evaluation and management; – extreme dorsiflexion required by the demiplie position in ballet can lead to impingement of anterior lip of … Read more

Ankle Sprain

Discussion pathoanatomy: fibular collateral ligament is made up of three separate structures; these are not as strong as medial ligaments, since lateral support of ankle is also provide by the fibula; anterior talofibular ligament calcaneofibular ligament posterior talofibular Ligaments cervical ligaments: ref: Elongation behavior of calcaneofibular and cervical ligaments during inversion loads applied in an … Read more

Ankle Valgus

Ankle Frx: Medial Clear Space vs Lateral Talar Shift

– Discussion: – w/ an “isolated fibular frx,” the paramount indication of an unstable frx is lateral talar shift (which indicates deltoid ligament injury); – this is manifested radiographically as an increase in the medial clear space; – normally the medial clear space (between talus & medial … Read more

Screw Fixation for Ankle Arthrodesis:

– Discussion: – select appropriately sized 6.5 mm or 7.0 mm canulated screw (threads must cross the frx site); – consider direction of maximal deformity and displacment; – guide wire insertion (for cannulated screw insertion); – K wire is inserted from deep w/ in sinus … Read more

Ankle Equinus: in CP

– See: Equinovarus: – Discussion: – most common problem; – in those w/ diplegia, it is bilateral & almost always flexible in child under three years; – diff dx: toe walking – Exam: – it is essential that the ankle and hindfoot be held in varus while … Read more

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 … Read more

Ankle Fracture Menu

– See: – Radiographic Studies – AO/Weber Classification & Surgical Treatment: – Type A – Type B (Antiglide Plate: ) – Type C – Antiglide Plate – Fracture Dislocations of the Ankle – Lateral Malleolar Fractures – Lauge Hansen Classification: – Pronation – Abduction Injuries – Pronation-External (Eversion) Rotation Injuries – Supination – Adduction Injuries – … Read more