medial malleolus avulsion fracture radiology

2014. Chandler Disease-- Idiopathic AVN of the femoral head in adult . The trauma is sometimes accompanied by ligament damage and dislocation. 6 Normal Variants and Anomalies ROBERT A. CHRISTMAN Thirty bones compose the foot and ankle complex. AP views show an avulsion at the distal tip of the lateral malleolus ( Figure 11-6 B ) and a transverse fracture of the lateral malleolus at the joint line ( Figure 11-6 C ). Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery. Fracture of the pedicles of C2. It bears 90% of the weight-bearing load, so this is a common fracture. Alignment is normal. Trimalleolar fx . (21) Axial CT scan demonstrates an avulsion fracture with minimal displacement of the avulsed fragment (arrows). This was marked off on the skin with a marker. high incidence of post-traumatic arthritis. Medial structures are under tension. Notice the oblique course on the lateral view. avulsion fracture 5 th metatarsal styloid: insertion of peroneus brevis tendon; superior peroneal retinaculum avulsion fracture; Radiographic features. Anatomy. Pull-off or Push-off fractures The shape of a fracture indicates which forces were involved. Salter-Harris Classification : Type I: 15% • fracture extends through the physis: Type II: 45% • fracture extends through the physis and exits through the metaphysis, forming a Thurston-Holland fragment Type III: 25% • fracture extends through the physis and exits through the epiphysis • seen with medial malleolus fractures and Tillaux fractures Although a medial malleolus fracture can be a serious injury, the outlook for recovery is good, and complications are rare. Medial flexor retinaculum injuries are not uncommon, but medial flexor retinaculum periosteal avulsion injuries are rare. It is bilateral in 25% population. If the bone is not displaced, a walking boot or a walking cast can be used, which will remain in situ for 4 to 6 weeks. (This number includes the distal tibia and fibula and the two sesamoids at the first metatarsophalangeal joint.) Medial compression, lateral traction forces: 1: Lateral malleolus fracture (Weber A) 2: Add vertical medial malleolus fracture: Pronation External rotation: Deltoid ligament under stress in pronation. Frontal (Fig. This is why it is always important to get an x-ray following a moderate to a severe ankle injury. An ankle fracture is a break of one or more ankle bones. Deltoid avulsion fracture. Most ankle fractures are malleolar fractures: 60–70% are unimalleolar (lateral being most common), 15–20% are bimalleolar, and 7–12% are trimalleolar (medial, lateral, and posterior malleoli) ( 2 ). Ankle mortise widens in ligament rupture. head avulsion fracture was also seen (coronal CT image). Deltoid ligament rupture or; a medial malleolar avulsion fracture. This information will guide you through the next 6 weeks of your rehabilitation. Stage I—transverse fracture of the medial malleolus or deltoid ligament tear. It is impossible to know which of these has happened following an ankle injury, without an x-ray. Bankart Fracture-- Satisfaction of search – in cases of multiple fractures, always search hard for the additonal subtle and hidden fracture. When the auto-complete results are available, use the up and down arrows to review and Enter to select. Here’s what you need to know. She reports having difficulty walking for more than a week after her acute injury. Straddle fracture • Bilateral fractures of the superior and inferior pubic rami. The bright line on the AP-view indicates a large tertius fracture fragment. Medial flexor retinaculum injuries are not uncommon, but medial flexor retinaculum periosteal avulsion injuries are rare. Which of the following statements accurately describe this radiograph? Traction forces cause the medial injury and impaction the lateral fracture. of the ankle that involves the lateral malleolus ,the medial malleolus, and the distal posterior aspect of the tibia , which can be termed posterior malleolus. Ankle fracture. In Stage 3, transverse or comminuted fibula fractures were observed above the level of the tibial plafond [ 12 ]. Department of Radiology, University Hospital Southampton Distal Radius ... Dorsal Capsular – Talus and Navicular Medial Tibial Plateau Posterior Tibial Plateau Lateral Talar Dome Medial Malleolus Top Tips 1. A medial malleolus fracture can include impaction or indenting of the ankle joint. If the broken bone punctures the skin, it is called an open or compound fracture. Touch device users can explore by touch or with swipe gestures. Transverse fracture of the medial malleolus. Advanced anterior and anteromedial osseous and, less commonly, soft-tissue impingement can produce opposing tibial and talar neck bone marrow edema, usually with easily depicted osteophytes [ 13 ] ( Fig. Most inversion injuries result in an isolated sprain of the anterior talofibular ligament. At reexamination you notice the subtle avulsion of the medial malleolus red arrowwhich is stage 1. 2, 9, 15, 16 In one case series, 15 17 of 20 patients with fractures were misdiagnosed with ankle sprains. Transverse fibula avulsion Fracture below syndesmosis and below talar dome and joint line; May be associated with a medial malleolus Fracture (oblique or vertical) or medial deltoid ligament tear; Syndesmosis intact, and nearly always stable (esp. Despite its rare occurrence, it is important to distinguish os subfibulare from an acute avulsion fracture of the lateral malleolus to avoid delayed fracture diagnosis that may lead to complications as malunion, nonunion, or a chronically painful ankle. ligaments or with a malleolar fracture. Very common: ∼187 ankle fractures per 100,000 people each year ( 1) Fractures to ankle or midfoot occur in <15% of ankle sprains. Radiographs demonstrating a fracture fragment posterior and medial to the talus are diagnostic of a Cedell posterior medial tubercle fracture. if no medial malleolus Fracture) Weber B (may be unstable) Fracture at the level of the talar dome Fractures commonly happen because of car accidents, falls or sports injuries. Again, these fractures have been commonly misdiagnosed as ankle sprains. This patient sustained a medial flexor retinaculum tear readily characterized at computed tomography by an associated proximal retinacular avulsion fracture from the posteromedial tibia. The suprasyndesdesmotic injury (type C fracture) The foot is in pronation; An external rotation force is applied. Figure 1 – Medial Malleolus Fracture Anatomy. Ankle undisplaced medial malleolus fracture. Explore. Many avulsion fractures are apparent of plain radiographs. Marked soft tissue swelling over the lateral malleolus with a small bony fragment and increased lucency at the tip which is suspicious for an avulsion fracture.

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