Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- recent trauma
- ankle pain and swelling
- inability to weight-bear
- medial and/or lateral malleolus swollen and tender to palpation
Outros fatores diagnósticos
- ankle deformity
- crepitus
- tenderness of the proximal fibula
- tenting of the skin over the medial malleolus
- Ottawa ankle rules
- history of osteoporosis
- history of frequent falls
- vascular compromise
Fatores de risco
- low-energy fall
- osteoporosis
- multiple falls
- inversion injury to ankle
- playing sports
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- plain radiograph
Investigações a serem consideradas
- plain radiograph "stress view" or a standing anteroposterior radiograph
- CT
- MRI
Algoritmo de tratamento
open fracture
closed fracture + dislocation
isolated lateral malleolar fracture
isolated medial malleolar fracture
bimalleolar/trimalleolar fracture
Colaboradores
Autores
Ewout S. Veltman, MD
Orthopaedic and Trauma Surgeon
Erasmus MC
Rotterdam
The Netherlands
Declarações
ESV declares that he has no competing interests.
Rudolf W. Poolman, MD, PhD
Consultant Orthopaedic Surgeon
Joint Research
Onze Lieve Vrouwe Gasthuis
Amsterdam
The Netherlands
Declarações
RWP has been a member of the Dutch Orthopedic Association Committee, has received grants for the ZonMW ESCAPE trial, DART trial, Achmea Escape trial and Van Rens Fonds REDEP trial, and has contributed to the following educational events: the Waldemar Link hip course and the J&J hip course.
Agradecimentos
Dr Ewout S. Veltman and Dr Rudolf W. Poolman would like to gratefully acknowledge Dr Mohit Bhandari and Dr Brad Petrisor, previous contributors to this topic, as well as Dr Victor A. van de Graaf and Dr Dirk P. ter Meulen for their assistance with the final draft. MB and BP declare that they have no competing interests.
Revisores
Charles Court-Brown, MB ChB
Professor of Orthopaedic Surgery
Consultant Orthopaedic Surgeon
Edinburgh Orthopaedic Trauma Unit
Royal Infirmary of Edinburgh
Edinburgh
UK
Declarações
CCB is an author of several references cited in this topic.
James C. Puffer, MD
Professor
University of Kentucky School of Medicine
President and Chief Executive Officer
American Board of Family Medicine
Lexington
KY
Declarações
JCP declares that he has no competing interests.
Philip H. Cohen, MD
Clinical Assistant Professor of Medicine
Robert Wood Johnson Medical School
University of Medicine and Dentistry of New Jersey
Piscataway
NJ
Declarações
PHC declares that he has no competing interests.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
British Orthopaedic Association Standards for Trauma. The management of ankle fractures. Aug 2016 [internet publication].Texto completo
American College of Radiology. ACR appropriateness criteria: acute trauma to the ankle. 2020 [internet publication].Texto completo
American Academy of Orthopedic Surgeons. Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline. Mar 2022 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Lateral ankle ligament tear (anterior talofibular ligament and calcaneofibular ligament)
- Achilles tendon rupture
- Talar fracture
Mais Diagnósticos diferenciaisDiretrizes
- Fracture management practice guideline
- Appropriate Use Criteria: prevention of surgical site infection after high energy extremity trauma
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