Ankle & Foot Fractures

• Ankle Fractures
• Tillaux Fractures
• Triplane Fractures

Ankle Fractures

• Supination Eversion
  • SH III or IV of the medial malleolus & SH I of the fibula
• Pronation External Rotation
  • Lateral Thorston Holland fragment – with SH II of the tibia
  • Fracture is above the fibular growth plate

Epiphyseal Injury

• SH I of  Fibula – cast
• SH II of tibia – closed reduction & cast
• ORIF if joint signigicantly displaced

Transitional Fractures

• Growth stops central & then moves medial & then circumferential to end at anterolateral

Tillaux

• Avulsion of the lateral distal tibial epiphysis by the syndesmosis
• Closed reduction & casting

Triplane

• Secondary to external rotation
  • Two part – one intraarticular & one extrarticular
  • Three part – the Tillaux fragment is a separate piece
  • Four part
• Consider a CT scan
• AP SH III
• Lat SH II
• ORIF if  joint displaced greater than 2 mm