Learning objectives
We aim to review basic foot and ankle anatomy,
as well as common types of adult foot and ankle fractures and their classification on conventional radiography and CT (predominantely),
including:
Medial / Lateral / Posterior / Bi and Tri Malleolar Fractures (ankle)
Pilon Fractures (ankle)
Calcaneus Fracture (heel)
Lisfranc Fracture dislocation (midfoot)
Base of 5th Metatarsal Fracture (midfoot)
Metatarsal Stress Fractures (midfoot)
Background
Lower extremity fractures involving the foot and ankle are common traumatic injuries that require imaging for purposes of diagnosis,
classification,
treatment planning and follow-up.
The foot is a complex weight bearing structure involving several small bones,
ligaments and tendons,
articulated with the lower leg in a synovial hinge joint known as the Talocrural joint or Ankle.
(Fig.
1 and 2)
Among these,
ankle fractures involving either medial,
lateral,
posterior malleolus or a combination of these make up the most common injuries of the distal lower...
Findings and procedure details
Ankle Fractures
Ankle fractures are the most common fractures of the lower extremity.
They can either involve the distal fibula – i.e.
Lateral malleolus fracture; or the distal tibia – i.e.
Medial or Posterior malleolus fractures.
The most commonly used classification for handling distal fibular fractures is the Weber Classification (Fig 4),
which relies on the level of fracture,
number of involved malleoli and associated ligament disruption to stage the injury and predict the need for surgical intervention.
In a nutshell,
the basic premise for...
Conclusion
Foot and ankle fractures are common and heavily rely on imaging for proper diagnosis and treatment planning,
allowing the radiologist to play an important role in patient management.
Being familiar with the several types of factures is important,
and even more important than what was discussed here is to be aware of the classifications used by one’s hospital Orthopedic Surgery department.
The classifications displayed here somewhat reflect our institutional preference and more than allowing for treatment planning,
they also enable the interpreting radiologist to actively...
References
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Davis ML,
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Epidemiology of foot and ankle fractures in the United States: an analysis of the National Trauma Data Bank (2007 to 2011).
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Scolaro J,
Ahn J,
Mehta S.
Lisfranc fracture dislocations.
Clin Orthop Relat Res.
2011;469(7):2078-80.
Goost H,
Wimmer* MD,
Barg A,
Kabir K,
Valderrabano V,
Burger C.
Fractures of the Ankle Joint: Investigation and Treatment Options.Deutsches Ärzteblatt International.
2014;111(21):377-388.
doi:10.3238/arztebl.2014.0377.
Hermans JJ,
Beumer A,
de Jong TAW,
Kleinrensink G-J.
Anatomy of the distal tibiofibular...