Executive Editor: Steve Krikler

Authors: Paulo Barbosa, Felix Bonnaire, Kodi Kojima

Malleoli Suprasyndesmotic multifragmentary fibula, medial injury, +/- posterior fracture - Long leg circular cast

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Postoperative treatment of ankle fractures treated with a cast/brace

If the patient complains of severe or increasing pain, the possibility of compartment syndrome or other circulatory disorders should be considered. The cast should be split or the brace loosened. If this does not result in a rapid improvement, the cast or brace should be removed.

Mobilize the patient as soon as possible. Weight bearing is allowed in stable fractures.

Remove the plaster if the patient feels pain, and check the soft tissues for pressure sores.

If the cast loosens, it should be changed and renewed. The cast is removed after 6 to 8 weeks.

Physiotherapy is then usually necessary for 2-4 weeks.

In some patients, additional swelling occurs after removal of the cast. This can be treated with an elastic bandage, or a compression stocking.

At 3 months, if there are symptoms of lateral instability, either inversion stress x-rays or MRI can be used to investigate lateral ligament integrity.

v1.0 2015-12-04