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Demo Question

With respect to ankle fractures, which of the following is correct?

 3 mm of talar shift leads to a decrease in tibiotalar contact by 50%

  A medial clear space > 4 mm is indicative of a deltoid ligament injury

 Concomitant osteochondral fractures of the talar dome are uncommon

 Syndesmosis injuries can only occur with a Weber C type fracture of the lateral malleolus

 The majority of fractures are due to a pronation external rotation injury

Key Learning Point

Normally the medial clear space (between talus and medial malleolus) should be less than 4 mm and when the medial space is > than 4 mm, then lateral shift of talus is present.

Explanation

The majority of fractures occur due to a supination- external rotation injury.

Syndesmosis injuries can occur with low as well as high fibula fractures.

Osteochondral defects can occur in up to 40% of ankle fractures in some series.

Normally the medial clear space (between talus and medial malleolus) should be less than 4 mm and when the medial space is > than 4 mm, then lateral shift of talus is present.

1mm of talar shift decreases tibiotalar contact by 50%.

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