Ankle Fractures,and Posterior Malleolar Fracture - Everything You Need To Know - Dr. Nabil Ebraheim скачать в хорошем качестве

Ankle Fractures,and Posterior Malleolar Fracture - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes fractures of the ankle, posterior malleolus fracture. Educational video describing fractures of the ankle X - rays. It describes ankle fracture classification, ankle fracture dislocation. It also describes ankle fracture treatment and ankle fracture surgery and ankle fracture recovery. This fracture is difficult to assess on standard lateral x-rays. We proposed that the external rotation lateral view will show that fracture better than the lateral x-ray. You can also get a CT scan. The indication for surgery is more than 25% joint involvement on the lateral x-ray, or more than 2 mm step-off, or if the fracture is associated with posterior subluxation of the talus after fixation of the other fractures. You fix the syndesmosis; you get about 40% of the syndesmosis strength, but if you fix this fracture you get about 70% of the syndesmosis strength, it appears that fixing the posterior malleolar fracture is at least equivalent in functional outcome to syndesmotic screw fixation. This fracture can give us trouble in deciding the actual size of the fracture fragment. The fracture is not in the coronal plane, it is attached to the fibula through the posterior inferior tibiofibular ligament, it seems like the posterior malleolar fragment separates from the tibia and goes with the fibula. It is obliquely oriented and it involves the incisura, and it is larger laterally than medially, the lateral external rotation view will show you the fracture better because it will orient the fracture better on x-ray. The posterior malleolar fracture can be seen as a part of a trimalleolar fracture and usually this injury is more complex. Sometimes the trimalleolar fractures have a smaller posterior fracture fragment that may not be seen at all and may not be required fixation. This posterior malleolar fracture, can have unusual presentation, for example: in pronation- abduction injury: an isolated posterior malleolar fracture may occur, because the injury stops before it fractures the fibula, so the injury will rupture the deltoid ligament as the first stage, then it will rupture the anterior tibiofibular ligament and will fracture the posterior malleolus. An isolated posterior malleolar fracture can be a part of the maisonneuve fracture. Isolated fractures of the posterior malleolus accounts for about 5% of tibial pilon fractures. Please dig deeper, isolated fractures of the posterior malleolus are rare and are usually a part of a complex injury such as the Maisonneuve fracture or pronation abduction fracture. Fracture of the posterior malleolus may be associated with a spiral tibial diaphysial fracture, especially in the distal third. Check the lateral x-ray view very carefully or get a CT scan, look for a posterior malleolar fracture. Treatment of the posterior malleolar fractures: You can use screws or plates to fix it, if you use screws, especially percutaneous screws anteriorly to posteriorly, watch out the neurovascular bundle, but you also can do it from posteriorly to anteriorly. You can approach it from a plate from the posterolateral (the common approach): between the perineal and the flexor halluces longus, or from postero-medial (less common). Become a friend on facebook:   / drebraheim   Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundati...