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Ankle Fracture For Radiologist

Only 15% show fractures.  Ottawa rule says , weight bearing immediately after injury or for the radiograph usually excludes severe bony injury.  Radiographs usually AP, Lat and Mortise view(15 to 20 deg internal rotation view)

• Look for (apart from routine bones, alignments ,and soft tissues and tibial plafond ) FLOAT-most commonly missed fractures, Fifth Metatarsal base, Lateral malleolus, Os trigonum or posterior malleolus, Anterior Process of calcaneum, and Talar dome

Radiographic evaluation

AP View

 Medial clear space of >3mm=deltoid/syndesmotic strain

 Tibifibular space<6mmis normal

 Standing AP, syndesmotic widening>3mm=syndesmotic strain

Mortise View

 Lateral clear space>2mm=syndesmotic strain

 TibioFibular overlap should be normally>1mm

 Normal medial clear space <4mm OR difference between medial and lateral <2mm

ALL displaced medial malleolar fractures and oblique fibular fractures proximal to joint by2-3 inches will have ligamentous injuries. Teaching points by Dr MGK Murthy.

Ankle Fracture For Radiologist Reviewed by Sumer Sethi on Tuesday, May 10, 2011 Rating: 5

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