Ankle Fracture Management and Treatment Techniques
Summary
Ankle fractures represent one of the most frequent lower-limb injuries worldwide, with patterns ranging from isolated lateral malleolar breaks to complex trimalleolar disruptions involving syndesmotic and ligamentous injuries. Initial assessment combines clinical examination with radiographic and three-dimensional imaging to classify fractures according to systems such as AO/OTA and Danis–Weber. Management strategies balance operative and nonoperative approaches, dictated by stability, fragment size and soft-tissue condition. Unstable fractures typically undergo open reduction and internal fixation (ORIF) using plates, screws or intramedullary devices. Recent innovations include minimally invasive fibular nailing and antiglide plating guided by detailed fracture mapping. Syndesmotic injuries may be stabilised with traditional screws or dynamic suture-button constructs, each offering distinct biomechanical profiles. Rehabilitation protocols have evolved from prolonged immobilisation towards early mobilisation and weight-bearing, which modern trials suggest can accelerate return to function without compromising healing. Controversies persist regarding fixation of small posterior malleolar fragments and indications for deltoid ligament repair. A comprehensive understanding of fracture morphology, fixation biomechanics and patient-centred outcomes underpins the global effort to optimise ankle fracture care and restore mobility.
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Ankle Fracture Management and Treatment Techniques publication trend
The graph below shows the total number of articles in ankle fracture management and treatment techniques across all publications each year (not limited to Nature Index journals).
Technical terms
Danis–Weber classification: A system categorising fibular fractures by their level relative to the ankle syndesmosis.
Olerud–Molander Ankle Score (OMAS): A patient-reported outcome measure evaluating pain, function and return to activity after ankle injury.
Open reduction and internal fixation (ORIF): Surgical realignment of a fracture and stabilisation with implants such as plates, screws or nails.
Syndesmotic injury: Disruption of the distal tibiofibular ligament complex, often occurring with higher ankle fractures and requiring specific fixation.
Suture-button device: A flexible fixation system for syndesmosis repair that permits physiological micromotion while maintaining reduction.
References
- Early versus delayed weight-bearing following operatively treated ankle fracture (WAX): a non-inferiority, multicentre, randomised controlled trial. The Lancet (2024).
- Operative vs Nonoperative Management of Unstable Medial Malleolus Fractures. JAMA Network Open (2024).
- Three-dimensional morphological study of type B lateral malleolar fractures with special reference to the end-tip location of proximal apexes. Frontiers in Bioengineering and Biotechnology (2023).
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