Only 15% show fractures. Ottawa rule says , weight bearing immediately after injury or for the radiograph usually excludes severe bony injury. Radiographs usually AP, Lat and Mortise view(15 to 20 deg internal rotation view)
• Look for (apart from routine bones, alignments ,and soft tissues and tibial plafond ) FLOAT-most commonly missed fractures, Fifth Metatarsal base, Lateral malleolus, Os trigonum or posterior malleolus, Anterior Process of calcaneum, and Talar dome
Radiographic evaluation
AP View
Medial clear space of >3mm=deltoid/syndesmotic strain
Tibifibular space<6mmis normal
Standing AP, syndesmotic widening>3mm=syndesmotic strain
Mortise View
Lateral clear space>2mm=syndesmotic strain
TibioFibular overlap should be normally>1mm
Normal medial clear space <4mm OR difference between medial and lateral <2mm
ALL displaced medial malleolar fractures and oblique fibular fractures proximal to joint by2-3 inches will have ligamentous injuries. Teaching points by Dr MGK Murthy.
• Look for (apart from routine bones, alignments ,and soft tissues and tibial plafond ) FLOAT-most commonly missed fractures, Fifth Metatarsal base, Lateral malleolus, Os trigonum or posterior malleolus, Anterior Process of calcaneum, and Talar dome
Radiographic evaluation
AP View
Medial clear space of >3mm=deltoid/syndesmotic strain
Tibifibular space<6mmis normal
Standing AP, syndesmotic widening>3mm=syndesmotic strain
Mortise View
Lateral clear space>2mm=syndesmotic strain
TibioFibular overlap should be normally>1mm
Normal medial clear space <4mm OR difference between medial and lateral <2mm
ALL displaced medial malleolar fractures and oblique fibular fractures proximal to joint by2-3 inches will have ligamentous injuries. Teaching points by Dr MGK Murthy.
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