When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Ankle fractures

Last reviewed: 21 Aug 2025
Last updated: 02 Jul 2024

Summary

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • recent trauma
  • ankle pain and swelling
  • inability to weight-bear
  • medial and/or lateral malleolus swollen and tender to palpation
Полная информация

Другие диагностические факторы

  • 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
Полная информация

Факторы риска

  • low-energy fall
  • osteoporosis
  • multiple falls
  • inversion injury to ankle
  • playing sports
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • plain radiograph
Полная информация

Исследования, проведение которых нужно рассмотреть

  • plain radiograph "stress view" or a standing anteroposterior radiograph
  • CT
  • MRI
Полная информация

Алгоритм лечения

Начальные

open fracture

closed fracture + dislocation

Острый

isolated lateral malleolar fracture

isolated medial malleolar fracture

bimalleolar/trimalleolar fracture

Составители

Авторы

Ewout S. Veltman, MD

Orthopaedic and Trauma Surgeon

Erasmus MC

Rotterdam

The Netherlands

Раскрытие информации

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

Раскрытие информации

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.

Выражение благодарностей

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.

Рецензенты

Charles Court-Brown, MB ChB

Professor of Orthopaedic Surgery

Consultant Orthopaedic Surgeon

Edinburgh Orthopaedic Trauma Unit

Royal Infirmary of Edinburgh

Edinburgh

UK

Раскрытие информации

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

Раскрытие информации

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

Раскрытие информации

PHC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

British Orthopaedic Association Standards for Trauma. The management of ankle fractures​. Aug 2016 [internet publication].Полный текст

American College of Radiology. ACR appropriateness criteria: acute trauma to the ankle. 2020 [internet publication].Полный текст

American Academy of Orthopedic Surgeons. Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline. Mar 2022 [internet publication].Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Использование этого контента попадает под действие нашего заявления об отказе от ответственности