Ankle fractures resulting from rotational injuries.

James D. Michelson

Research output: Contribution to journalReview articlepeer-review

81 Scopus citations


Ankle fractures are among the most common skeletal injuries; selection of an optimal management method depends on ankle stability. Stable fractures (eg, isolated lateral malleolar) generally are managed nonsurgically; unstable fractures (eg, bimalleolar, bimalleolar equivalent) usually are managed with open reduction and internal fixation. Stress radiographs may aid in the management of incomplete deltoid injury in which there is medial swelling and tenderness without radiographic talar shift. A posterior malleolar fracture should be reduced and stabilized if it comprises >30% of the articular surface and remains displaced after fibular stabilization. Ankle fractures with syndesmotic injury have additional tibiofibular instability that can be controlled by screw fixation. However, the choice between metal and bioabsorbable screws, screw size, number of cortices fixed, and indications for screw removal remain controversial. Conditions such as diabetes or advanced age are no longer contraindications to usual management recommendations.

Original languageEnglish (US)
Pages (from-to)403-412
Number of pages10
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Issue number6
StatePublished - Jan 1 2003

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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