The Treatment of Oblique Fractures of the Fibula

¹ Leo Mayer Orthopaedic Group and the Hospital for Joint Diseases, New York

To provide adequate treatment for patients with oblique fractures of the fibula, the extent of ligamentous damage must first be determined. This is best done by making lateral-rotation, stress roentgenograms of the ankle. If the ligamentous damage is not sufficient to impair stability, a plaster-of-Paris boot to below the knee provides sufficient immobilization. If, however, the damage is sufficient to create lateral ankle instability, then, after the displacement of the talus has been reduced, the ankle must be immobilized in a plaster cast that extends above the flexed knee. This holds the foot in slight medial rotation and prevents lateral rotation and displacement of the talus and distal fibular fragment. Such non-operative treatment has given almost uniformly satisfactory results, especially when used soon after injury and before the torn ligament ends are surrounded by scar tissue. Occasionally, surgery may be necessary to reduce the displacement of the talus, but operative repair of the ligamentous injury is not required.

There is, apparently, no reconstructive operation for persistent lateral ankle instability which offers results as good as those achieved by the proper initial treatment; therefore, early recognition of the injury and appropriate treatment are urgent.

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