Executive Editor: Steve Krikler

Authors: Paulo Barbosa, Felix Bonnaire, Kodi Kojima

Malleoli Infrasyndesmotic, lateral isolated fracture

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1 Indication top

Functional treatment is indicated only for stable fractures.

Functional treatment can also be indicated following ORIF of unstable fractures.

With functional treatment, movement of the ankle joint is possible.

2 Functional treatment top



Usually, functional treatment should continue for about 6 weeks after injury.

Elastic bandages, functional braces, and compression stockings support the soft tissues. Remove the brace if the patient feels pain, and check the soft tissues for pressure sores.

Mobilize the patient as soon as possible. Physiotherapy can be helpful (joint movements, lymphatic drainage, manual therapy). Weight bearing is allowed within the limits of any pain and / or swelling.

Check x-rays are taken after 3 and 6 weeks.

Without immobilization, pharmaceutical thromboembolic prophylaxis is only indicated in high risk patients.

Non-steroidal anti-inflammatory medication helps to relieve pain and swelling.

Additional swelling may occur after removal of the brace. 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, are used to investigate lateral ligament integrity.

v1.0 2015-12-04