fusion=neutral dorsiflexion, 5-10°valgus, 5-10 external rotation, neutral mediolateral displacement, posterior translation of the talus with respect to the tibia of 1cm.Dorsiflexion causes ER of talus and posterlateral translation and ER of fibula. Saphenous nerve supplies medial NWB side of middle and hind foot. Saphenous nerve runs with long saphenous vein in front of medial malleolus usually dividing into two branches running on either side of the vein. saphenous nerve and posterior tibial nerve medially.superficial peroneal n & sural n lateral.PITFL runs from posterior malleolus ie Volkmann's tubercle. AITFL runs from Chaputs tubercle on anterolateral tibia to Wagstaffe's tubercle on anterior lateral malleolus. syndesmosis=anterior inferior tibiofibular(intracapsular), posterior inferior tibiofibular, inferior transverse, interosseus.lateral ligaments=anterior talofibular, calcaneofibular, posterior talofibular.Deep deltoid is from posterior colliculus of tibia to talus Superficial deltoid is from anterior colliculus of medial malleolus to. medial ligaments=superficial & deep(strongest) deltoid.10 dorsiflexion required for normal gait, 20-30 for athletics. ROM=32 dorsiflexion, 45 plantar flexion.Unstable fractures treated non-operatively can lead to increased lateral malleolar malunion, medial maleolar nonunion, delayed rehab,.3 openĪnkle Fracture Etiology / Epidemiology / Natural History A=Initial encounter for closed fracture, B=Initial encounter for open fracture type I or II, C=Initial encounter for open fracture type IIIA, IIIB, or IIIC, D=subsequent encounter for closed fracture with routine healing, E=subsequent encounter for open fracture type I or II with routine healing, F=subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing, G=subsequent encounter for closed fracture with delayed healing, H=subsequent encounter for open fracture type I or II with delayed healing, J=subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing, K=subsequent encounter for closed fracture with nonunion, M=subsequent encounter for open fracture type I or II with nonunion, N=subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion, P=subsequent encounter for closed fracture with malunion, Q=subsequent encounter for open fracture type I or II with malunion, R= subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion, S=sequela.S82.856(A-S) - Nondisplaced trimalleolar fracture of unspecified lower leg.S82.855(A-S) - Nondisplaced trimalleolar fracture of left lower leg.S82.854(A-S) - Nondisplaced trimalleolar fracture of right lower leg.S82.853(A-S) - Displaced trimalleolar fracture of unspecified lower leg.S82.852(A-S) - Displaced trimalleolar fracture of left lower leg.S82.851(A-S) - Displaced trimalleolar fracture of right lower leg.S82.846(A-S) - Nondisplaced bimalleolar fracture of unspecified lower leg.S82.845(A-S) - Nondisplaced bimalleolar fracture of left lower leg.S82.844(A-S) - Nondisplaced bimalleolar fracture of right lower leg.S82.843(A-S) - Displaced bimalleolar fracture of unspecified lower leg.S82.842( A-S) -Displaced bimalleolar fracture of left lower leg.S82.841(A-S) - Displaced bimalleolar fracture of right lower leg.Synonyms: medial malleolus fracture, lateral malleolus fracture, bimalleolar fracture, posterior mallelous fracture, trimalleolar ankle fracture Associated Injuries / Differential Diagnosis
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