Ankle Fractures

Description

Professor Matthew Costa gives his expert insights and discusses the evolving approach to treating ankle fractures based on recent studies and trials. He emphasizes a shift towards non-operative treatments, particularly for un-displaced ankle fractures, advocating for the use of walking boots that allow for unrestricted mobilization rather than traditional casting. Professor Costa highlights significant findings from trials such as the AIR trial and the WAX trial, which support immediate weight-bearing as a safe option for patients.



Professor Costa outlines his protocol for managing un-displaced fractures, including regular monitoring with X-rays to ensure stability. He describes using a close contact cast for patients unable to maintain stability with a walking boot, allowing for weight-bearing to promote natural healing. Surgery is reserved for cases where non-operative methods fail, predominantly using internal fixation and screws to restore the fibula's anatomy.



He discusses the complexities of treating bimalleolar fractures, weighing the decision to fix the medial malleolus and addressing potential fibrous non-unions. Additionally, he reflects on the management of posterior malleolus fractures, noting that smaller fragments may not require fixation if they do not compromise functional outcomes. Throughout, Professor Costa expresses a cautious approach to surgery, preferring minimally invasive solutions when feasible.




This Expert Insight answers questions asked in our new platform BJJ Life

DOI: 10.1302/3114-251100

Specialties