Dr. Ebraheim’s educational animated video describing the anatomy the injury the diagnosis and treatment of ankle fracture.
Surgical tactics and strategy.
The goal of surgery is to reduce the talus in an anatomical position under the tibia.
Once the fractures have been fixed then stress views can be used to rule out a syndesmotic injury. The most effective method utilized to rule out the presence of syndesmotic injury is the use of stress view examinations.
Rule out syndesmotic injury using intraoperative stress views which is the most relieable method.
Check medial clear space which is the distance between the lateral border of the medial malleolus and the medial border of the talus, measured at the level of the talar dome.
Check tibiofibular clear space.
Direct inspection of the syndesmosis: excessive movement of the fibula with the use of a bone hook is another diagnostic method for syndesmotic injury. Excessive movement is abnormal.
How do you do the intraoperative stress views?
•Place ankle into neutral position.
•Apply external rotation stress.
•Get mortise view radiograph.
Syndesmotic injury fixation
•Reduction
•Screw fixation

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