Ankle Fracture
Ankle-fracture management is driven by skin and neurovascular status, mortise stability and patient factors: urgent reduction for deformity, appropriate radiographs and CT for complex patterns, weight-bearing treatment for stable injuries, and timely fixation or specialist non-operative care for unstable injuries.
Definition
An ankle fracture is a break involving the malleoli or distal tibial/fibular structures around the ankle mortise, often with associated syndesmotic or ligamentous injury. Treatment depends on stability, alignment, soft tissues and patient factors.
First principles
The ankle mortise is a stabilising ring around the talus
The mortise is formed by the distal tibia and fibula with the syndesmosis and medial and lateral ligament complexes. A rotational injury may fail the ring at more than one point, through malleolar fractures, syndesmotic disruption, a posterior malleolar fracture or deltoid-ligament failure. The key question is whether the talus remains centred and the mortise remains stable, not simply which malleolus is broken.
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