Q) In a patient with an ankle fracture where there was a spiral fracture of the lateral malleolus, what is the treatment of choice?
a) compression screws
b) tension banding wiring
c) buttress plating
d) no treatment required
Ans: a) (Maheshwari 3rd,revised Ed., 139)
The following techniques of internal fixation are used in ankle fracture depending on the type of fracture:
1. Medial malleolus fracture:
· Transverse fracture-compression screw, tension band wiring
· Oblique fracture-compression screws
· Avulsion fracture-tension band wiring
2. Lateral malleolus fracture:
· Transverse fracture-tension band wiring
· Spiral fracture-compression screws
· Comminuted fracture-buttress plating
· Fracture of the lower third of fibula-4 hole plate
3. posterior malleolus:
· involving less than one third of the articulating surface of the tibia- no additional treatment
· involving more than one-third of the articulating surface of the tibia-internal fixation with compression screws.
· Tibio-fibular syndesmosis disruption-inserting a long screw from the fibula into the tibia.
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