INJURIES AROUND THE ANKLE (Pott’s Fracture)

Ankle REF: http://en.wikipedia.org/wiki/List_of_eponymous_fractures See APPENDIX-68 for “Alphabetical list of eponymous fractures”

Ankle

A i.e. Rupture of anterior talo-fibular ligament

C i.e. Sprain of extensor digitorum brevis

Inversion injury of ankle cause peroneal tendon sheath (not extensor digitorum brevis) sprain.

Inversion Injury to ankle may lead to

–   Lateral collateral ligament injury (anterior talo fibularQ> calcaneofibular > posterior – talofibular ligament)

–  Peroneal tendon injuryQ

–  Avulsion fracture of tip of lateral mallelusQ

–  Avulsion fracture of anterolateral surface of talus & calcaneum (sustentaculum tali)Q.

–  Fracture of base of 5^th metatarsalQ.

D i.e. Ankle

A i.e. Inversion of foot

Ans. is ‘a’ i.e., Anterior talofibular ligament

• The ankle is one of the most common sites for acute musculoskeletal injuries. Sprains constitute 85% of all ankle injuries, and 85% of those involve a lateral inversion mechanism.
• Inversion Sprain – Inversion ankle sprains occur when the foot turns in or out to an abnormal degree relative to the ankle. The most common mechanism of an ankle sprain is a combination of plantarflexion and inversion where the foot is pointing downward and inward.
• The lateral ligaments are involved in an inversion ankle sprain and hence most commonly damaged. These ligaments are on the outside of the ankle, which includes the anterior talofibular (ATFL), calcaneofibular (CFL) and posterior talofibular ligaments (PTFL). Injury to the ATFL is the most common. When both the ATFL and CFL are injured together, ankle instability will be more noticeable. The PTFL is the strongest of the three ligaments and is rarely injured in an inversion sprain.

Ans:C.)Pott’s Fracture

Pott’s Fracture

• Fracture of the lower end of the fibula and medial malleolus of the tibia with rupture of the internal lateral ligament of the ankle, caused by outward and backward displacement of the leg while the foot is fixed.
• Pott’s fracture (also: Bimalleolar fractures) involve at least 2 elements of the ankle ring. These fractures should be considered unstable and require urgent orthopedic attention.

Ans:B.)Cotton Fracture.

Image shows:

• The Anterior-Posterior (AP) image shows fractures of both the lateral malleolus and medial malleolus.
• The lateral image shows an additional fracture line passing in the coronal plane to the articular surface of the tibia
• The posterior corner of the tibia is also known as the ‘posterior malleolus’.

Cotton Fracture(Trimalleolar Fracture)

• A trimalleolar fracture is a fracture of the ankle that involves the lateral malleolus, the medial malleolus, and the distal posterior aspect of the tibia, which can be termed the posterior malleolus.
• Surgical repair using open reduction and internal fixation is generally required