ORTHOPAEDICS - ADULT
ANKLE FRACTURE
Make sure to mention syndesmosis injury in XR report
PromptIndications for ANKLE xray described by Ottowa ankle rules
ResponseBone tenderness along the distal 6cm of the posterior edge of the tibia, or tip of the medial mal
OR
Bone tenderness along the distal 6cm of the posterior edge of the fibular or tip of the lateral mal
OR
Inability to weight bare both immediately and in the ED >=4 steps
OR
Bone tenderness along the distal 6cm of the posterior edge of the fibular or tip of the lateral mal
OR
Inability to weight bare both immediately and in the ED >=4 steps
PromptWEBER C
Response
Prompt
ResponseMaisonneuve fracture = high weber C ankle fracture
Disruption of tibiofibular syndesmosis
Complications
Compartment Syndrome
Common/deep peroneal nerve injury
Disruption of tibiofibular syndesmosis
Complications
Compartment Syndrome
Common/deep peroneal nerve injury
Prompt
ResponseWeber C distal fibular #/dislocatoin
Oblique fracture distal fibula
Lateral displacement talus (Widening of medial joint space)
Widened syndesmosis distal tib-fib
Oblique fracture distal fibula
Lateral displacement talus (Widening of medial joint space)
Widened syndesmosis distal tib-fib
PromptWEBER B
Response
Prompt
ResponseMedial malleolar fracture tibia
Weber B fibular fracture - at level of syndesmosis
Lateral talar displacement
Posterior malleolar fracture - posterior tibia
= Unstable ankle fracture requiring ORIF
Weber B fibular fracture - at level of syndesmosis
Lateral talar displacement
Posterior malleolar fracture - posterior tibia
= Unstable ankle fracture requiring ORIF
Prompt
ResponseWeber B distal fibular fracture
Lateral talar shift
Widening of tibio-fibular syndesmosis
Sof tissue swelling
Lateral talar shift
Widening of tibio-fibular syndesmosis
Sof tissue swelling
PromptManagement of displaced ankle fracture, or Lisfranc, or most things below knee:
ResponseAnalgesia - fentanyl
Procedural sedation for short leg backslab (+/- reduction)
Elevation + ice
Orthopaedics admission for ORIF (NBM pending review)
(Check for other injuries, ADT if abrasions/cuts, IVABx if open)
Procedural sedation for short leg backslab (+/- reduction)
Elevation + ice
Orthopaedics admission for ORIF (NBM pending review)
(Check for other injuries, ADT if abrasions/cuts, IVABx if open)